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The purpose of this study was to clarify the public health nurse's work and decision-making process in child health care during the years 1976-1986. The first study was carried out in 1976 and a subsequent one in 1986. The population of both studies consisted of public health nurses working in child health care centres. During these years many reforms were implemented in national child health care policy. According to the results of the 1986 study the public health nurses used the decision-making process, as a whole, better than in the study of 1976. The content of the health care they provided had become more varied.