Southall D P, Burr S, Smith R D, Bull D N, Radford A, Williams A, Nicholson S
Child Advocacy International and the Department of Paediatrics, Keele University, Keele, United Kingdom
Pediatrics. 2000 Nov;106(5):1054-64. doi: 10.1542/peds.106.5.1054.
Although modern medical technology and treatment regimens in well-resourced countries have improved the survival of sick or injured children, most of the world's families do not have access to adequate health care. Many hospitals in poorly resourced countries do not have basic water and sanitation, a reliable electricity supply, or even minimal security. The staff, both clinical and nonclinical, are often underpaid and sometimes undervalued by their communities. In many countries there continues to be minimal, if any, pain control, and the indiscriminate use of powerful antibiotics leads to a proliferation of multiresistant pathogens. Even in well-resourced countries, advances in health care have not always been accompanied by commensurate attention to the child's wider well-being and sufficient concerns about their anxieties, fears, and suffering. In accordance with the United Nations Convention on the Rights of the Child,(1) the proposals set out in this article aim to develop a system of care that will focus on the physical, psychological, and emotional well-being of children attending health care facilities, particularly as inpatients.
To develop in consultation with local health care professionals and international organizations, globally applicable standards that will help to ensure that practices in hospitals and health centers everywhere respect children's rights, not only to survival and avoidance of morbidity, but also to their protection from unnecessary suffering and their informed participation in treatment. Child Advocacy International will liase closely with the Department of Child and Adolescent Health and Development of the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) in the implementation of the pilot scheme in 6 countries. In hospitals providing maternity and newborn infant care, the program will be closely linked with the Baby Friendly Hospital Initiative of WHO/UNICEF that aims to strengthen support for breastfeeding. United Nations Children's Fund, United Nations Convention on the Rights of the Child, child protection, breastfeeding, pain control, palliative care, child abuse.
尽管资源丰富国家的现代医疗技术和治疗方案提高了患病或受伤儿童的存活率,但世界上大多数家庭无法获得足够的医疗保健。资源匮乏国家的许多医院没有基本的水和卫生设施、可靠的电力供应,甚至连最基本的安全保障都没有。临床和非临床工作人员的薪酬往往很低,有时还得不到社区的重视。在许多国家,疼痛控制即便有也极其有限,强力抗生素的滥用导致多重耐药病原体大量滋生。即使在资源丰富的国家,医疗保健的进步也并非总是伴随着对儿童更广泛福祉的相应关注,以及对他们的焦虑、恐惧和痛苦的充分关切。根据《联合国儿童权利公约》,(1) 本文提出的建议旨在建立一个护理系统,该系统将关注前往医疗保健机构(尤其是住院患儿)的儿童的身体、心理和情感福祉。
与当地医疗保健专业人员和国际组织协商制定全球适用的标准,以确保各地医院和健康中心的做法尊重儿童权利,不仅是生存权和避免发病的权利,还包括保护他们免受不必要的痛苦以及让他们知情参与治疗。儿童权益倡导国际组织将在6个国家实施试点计划时与世界卫生组织(世卫组织)儿童与青少年健康及发展司和联合国儿童基金会(儿基会)密切联络。在提供孕产妇和新生儿护理的医院,该项目将与世卫组织/儿基会的爱婴医院倡议紧密相连,该倡议旨在加强对母乳喂养的支持。联合国儿童基金会、《联合国儿童权利公约》、儿童保护、母乳喂养、疼痛控制、姑息治疗、虐待儿童。