Examining the social construction of surveillance: A critical issue for health visitors and public health nurses working with mothers and children.

AIMS AND OBJECTIVES: To critically examine surveillance practices of health visitors (HV) in the UK and public health nurses (PHNs) in Canada.

BACKGROUND: The practice and meaning of surveillance shifts and changes depending on the context and intent of relationships between mothers and HVs or PHNs.

DESIGN: We present the context and practice of HVs in the UK and PHNs in Canada and provide a comprehensive literature review regarding surveillance of mothers within public health systems. We then present our critique of the meaning and practice of surveillance across different settings.

METHODS: Concepts from Foucault and discourse analysis are used to critically examine and discuss the meaning of surveillance.

RESULTS: Surveillance is a complex concept that shifts meaning and is socially and institutionally constructed through relations of power.

CONCLUSIONS: Healthcare providers need to understand the different meanings and practices associated with surveillance to effectively inform practice.

RELEVANCE TO CLINICAL PRACTICE: Healthcare providers should be aware of how their positions of expert and privilege within healthcare systems affect relationships with mothers. A more comprehensive understanding of personal, social and institutional aspects of surveillance will provide opportunities to reflect upon and change practices that are supportive of mothers and their families.