Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis, Minnesota;
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatrics. 2018 Jul;142(1). doi: 10.1542/peds.2017-2966. Epub 2018 Jun 12.
Appeals for health equity call for departments of pediatrics to improve the health of all children including those from underserved communities in North America and around the world. Consequently, North American (NA) departments of pediatrics have a role in global child health (GCH) which focuses on providing health care to underserved children worldwide. In this review, we describe how NA departments of pediatrics can collaboratively engage in GCH education, clinical practice, research, and advocacy and summarize best practices, challenges, and next steps for engaging in GCH in each of these areas. For GCH in low- and middle-income countries (LMICs), best practices start with the establishment of ethical, equitable, and collaborative partnerships with LMIC communities, organizations, and institutions engaged in GCH who are responsible for the vast majority of work done in GCH. Other best practices include adequate preparation of trainees and clinicians for GCH experiences; alignment with local clinical and research priorities; contributions to local professional development and ongoing monitoring and evaluation. Challenges for departments include generating funding for GCH activities; recruitment and retention of GCH-focused faculty members; and challenges meeting best practices, particularly adequate preparation of trainees and clinicians and ensuring mutual benefit and reciprocity in NA-LMIC collaborations. We provide examples of how departments have overcome these challenges and suggest next steps for development of the role of NA departments of pediatrics in GCH. Collaborative implementation of best practices in GCH by LMIC-NA partnerships can contribute to reductions of child mortality and morbidity globally.
呼吁公平健康,要求儿科部门改善所有儿童的健康,包括北美和世界各地服务不足社区的儿童。因此,北美(NA)儿科部门在全球儿童健康(GCH)中发挥作用,重点是为全球服务不足的儿童提供医疗保健。在这篇综述中,我们描述了 NA 儿科部门如何能够在 GCH 教育、临床实践、研究和宣传方面进行协作,并总结了在这些领域参与 GCH 的最佳实践、挑战和下一步措施。对于低收入和中等收入国家(LMICs)的 GCH,最佳实践始于与参与 GCH 的 LMIC 社区、组织和机构建立道德、公平和合作伙伴关系,这些社区、组织和机构负责 GCH 工作的绝大部分。其他最佳实践包括为 GCH 经验充分准备学员和临床医生;与当地临床和研究重点保持一致;为当地专业发展做出贡献,并进行持续监测和评估。部门面临的挑战包括为 GCH 活动筹集资金;招聘和留住专注于 GCH 的教职员工;以及满足最佳实践的挑战,特别是充分准备学员和临床医生,并确保在 NA-LMIC 合作中实现互利互惠。我们提供了一些部门如何克服这些挑战的例子,并为 NA 儿科部门在 GCH 中的角色发展提出了下一步措施。LMIC-NA 伙伴关系协作实施 GCH 的最佳实践,可以为全球减少儿童死亡率和发病率做出贡献。