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Navigating paradox in child welfare: implications for improvement science in complex human service systems
Christina Evaldsson1,2, Sofia Kjellström1
1The Jönköping Academy of Improvement and Leadership, Department of Quality Improvement and Leadership, Jönköping University, Jönköping, Sweden.
Frontiers in Health Services
|April 10, 2026
Summary
Child welfare professionals navigate quality by balancing uniformity and responsiveness. Understanding this paradox is key for improvement science in human service systems.
Area of Science:
- Explores the intersection of improvement science and social care quality.
- Focuses on understanding quality in complex human service systems.
Background:
- Improvement science, primarily developed in healthcare, needs adaptation for social care.
- Quality in social care is complex and context-dependent, requiring deeper investigation.
Purpose of the Study:
- To explore how child welfare professionals in Sweden understand and enact quality.
- To provide implications for improvement science in complex human service systems.
Main Methods:
- Qualitative, practice-oriented, and interactive research design.
- Data from 28 semi-structured interviews, an analysis seminar, and documents.
- Inductive content analysis for theme construction.
Main Results:
- Identified two coexisting logics of quality: uniformity and responsiveness.
- Professionals dynamically shift between these logics in daily practice.
- Quality is enacted through negotiation of multiple, often conflicting, logics.
Conclusions:
- Quality in child welfare is a negotiated, paradoxical construct.
- Sustainable improvement requires balancing generalizable and contextual knowledge.
- Recognizing paradoxes is crucial for improvement science in human services.
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