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In addition to the above duties the Health Visitor is at the call of any resident in her district
who wishes to obtain her advice on matters appertaining to health. The Health Visitor reports daily
to the Medical Officer in charge of her district.
Qualifications of Health Visitors.
The Willesden Urban District Council require their Health Visitors to be :—
(a) Fully trained General Nurses.
(b) Certified Midwives.
(c) Certified Sanitary Inspectors or Health Visitors.
In addition to the above qualifications certain characteristics are necessary in the good Health
Visitor. Her mission is not an easy one, and it must be remembered that she has no right of entry,
but approaches the home as a " visitor " in the literal sense of the word. Plenty of tact and a pleasing
manner and address are therefore essential if she would gain the goodwill and confidence of her people.
Some sense of humour in conjunction with a thorough knowledge of her work and plenty of common
sense go far to make the successful Health Visitor.
Rationale of Health Visiting.
This may conveniently be discussed under the same headings as the scope of work.
A. Maternity and Child Welfare.
The chief objects of Health Visiting under this heading are :—
(1) The reduction of Maternal Mortality.
(2) The reduction of Chronic Disabilities in the mother following childbirth.
(3) The reduction of Infant Mortality.
(4) The Supervision of the Pre-School Child and the setting out in life of an A1 citizen.
Unfortunately, there are still every year a large number of women who lose their lives in childbirth
and, on the examination of statistics, it would appear that many of these could have been saved
if only efficient ante-natal care had been given. The public are gradually becoming educated regarding
the need for ante-natal supervision, but there are still many mothers who through ignorance or
press of domestic duties do not seek advice until labour has actually commenced or some complication
has arisen. It is with this latter class that the Health Visitor may use her influence. Being as she is
a certified midwife, she is able on her visits to note from the patient's statements and symptoms any
danger signals and urge her to obtain medical advice before it is too late. In the same way the Health
Visitor may prevent much chronic disability and invalidism in the nursing mother by explaining to
her the importance of getting suitable treatment for any injuries received at the time of the confinement.
The reduction of Infant Mortality has been receiving great public attention for some years past,
and from the following figures for Willesden I think one is justified in attributing the reduction in great
part to the work of the Health Visitors :—
1902—130 deaths per 1,000 births occurred. (The year before the appointment of first
Health Visitor.)
1922— 59
1923— 53 ,, „ ,,
1924— 73
1925— 62
Artificially fed children are found to be more prone to disease than those who receive the natural
breast milk, therefore the Health Visitor's aim must be to encourage wherever possible breast feeding.
With the advance of civilization and the hurry of modern life the tendency is gradually towards the
use of patent foods and dried milks, but the following figures would suggest that the work of the Health
Visitors is bearing some fruit in this direction also :—
Children, under the observation of the Health Visitors, who were:—
A. Entirely breast fed for 9 months. B. Solely hand fed from birth.
During 1920—15 per cent. During 1920—6 per cent.
1921—17 „ „ 1921—7
1922—22 „ „ 1922—5
1923—22 „ „ 1923—7
1924—19 „ „ 1924—4
1925—19 „ „ 1925—4
The period from 2—5 years in the life of the child is not under such constant supervision as the
first year and during this time many ailments occur which are not discovered until the child comes under
observation again at school medical inspection at the age of 5 years, e.g., discharging ears, enlarged
tonsils and adenoids, neglected rickets, etc. A large number of mothers now bring their babies to
the infant welfare centres pretty constantly during the first 12-18 months, but after that the attendances
drop off, and it then falls to the lot of the Health Visitor to keep these " Toddlers " under
supervision in their homes.