Moms of Tomislavgrad have patronage nurse: "Julija is always there for us – day or night, whenever you need her!"

"Had I only had Julija by my side when I gave birth to Erdan, things would have been much easier for me. Since I gave birth to little Edna eight months ago, I've had Julija visit me, she's been there day or night, whenever you need her, we call her in, ask for advice, things can't get better than this", Mom Almeida is full of praise for the patronage nurse from the Health Centre in Tomislav, Julija Barišić, with whom the patronage service of the Health Centre in Tomislavgrad returned as part of early growth and development services.

Home visiting with Julija. Today, Julija is going to visit three babies and their moms, check on how the babies are progressing, in particular the condition of the umbilical stump, which is usually a mom's greatest worry - especially first-time moms; she always has baby scales and forms the moms are asked to fill in once Julija has informed them of the activities the Early Development Centre implements, in which they are welcome to participate.

"The children of Tomislavgrad are born in Livno because the maternity ward has been temporarily closed here". I'm in permanent contact with the maternity ward in Livno and I visit every baby within 24 hours after birth, unless there are complications and the mother needs to stay in hospital a bit longer, or there is something else that is beyond control. I see every child at least three or four times a month in the first months or even more frequently if I find it necessary; later on, the visits are less frequent, but I regularly monitor the progress of every child until he or she turns one", said Julia while we were driving afield.

Improper nutrition: "In particular, I emphasise the importance of proper nutrition because I often see that babies are fed inadequately, and it takes a lot of work to improve things", says Julija.

She  recently visited Almedina, the mom from the beginning of this story; Almedina lives in the same building as Fatima Julija is visiting, and she has decided to come along with her baby for another piece of advice.

"Moms always welcome a piece of advice, they do not hesitate to ask about anything they'd like to know", says Julija while we are climbing up the stairs to Fatima's apartment, where little Riad, born some 20 days ago, is waiting for us. The baby needs to be weighed anew and Julija has special small scales that play music when the baby is placed on. The baby is gaining weight as he should, but Mom Fatima is very concerned about his umbilical stump:

"It fell off the other day, I hope everything's right", she's saying in a worried tone while Julija is examining the baby.

"The stump is fine, no need to worry there", explains Julija after the examination. Riad is Fatima's first-born, and she's full of praise for Julija and the fact that a patronage nurse is available now. Her mother Aida is there as well, who says that she didn't have such services when she gave birth to Fatima.

"When I had Fatima, there was no patronage nurse, we had to manage on our own and had to take her regularly all the way to the Health Centre. What we have now is simply great", says nanny Aida.

Baby Augustina, born less than ten weeks before Julija's first home visit, is the next one on our schedule. Mom Bernardina welcomes Julija; although she is a doctor and has Ante, a four and a half year old boy, Julija's advice and help are always welcome.

"It's much easier now than when I had the first baby; Julija's approach is excellent, she is good with babies and simply instils confidence; mothers follow her advice, call her and consult about anything they'd like to know or simply seek reassurance. It's very important to have the baby examined at the clinic but it is priceless to have someone see the baby in the environment she lives in", says Bernardina, while Julia is examining baby Augustina and concludes that things are just as they should be. She schedules the next call with Bernardina.

On visiting the babies, Julija prepares for the following day making a schedule of other visits.  To visit a baby who lives the farthest from the Health Centre she has to travel 37 kilometres; some babies live in the surrounding villages, some live downtown. As a matter of early growth and development, patronage visits are very important because most conditions are treatable and correctible if detected in timely manner.


"It is very important to recognise anything unusual in a timely manner, at least things that are evident, such as a club foot.  In case of any doubt, I contact the paediatrician, and Renata, the speech therapist, and other colleagues; we make sure we have full control of a child in the course of the first year of life. I'm currently consulting Renata about a boy I think we should examine together", says Julija, underlining the importance of education the parents get during her visits.

"The parents do not need to look around for information any longer. In addition to things related to the child, I also discuss the importance of immunisation and need to have the child vaccinated against communicable diseases, but other topics as well. In particular, I emphasise the importance of proper nutrition because I often see that babies are fed inadequately, and it takes a lot of work to improve things", says Julija.
 
Importance of visits: "It's very important to have the baby examined at the clinic, but  it is priceless to have someone see the baby in the environment she lives in", says Mom Bernardina

She notes the training she received while taking part in the training delivered by the Association "Education for All" (EDUS) and organised with the support of the UNICEF as part of the early growth and development improvement efforts.

"The training course was quite hands-on, we learned things we would need in our everyday work and how to apply new methods to everyday situations. I learnt new things I now use on a daily basis, which I find quite useful", says Julija.

Tomislavgrad is one of the municipalities that joined the Protocol on cooperation in the early growth and development area. The Protocol was signed and the early growth and development services were developed under the Applying the human security concept to stabilise communities in Canton 10 project, funded by the UN Trust Fund for Human Security and implemented by UN agencies in BiH (UNICEF, IOM, UNHCR and UNDP).