Zimmerman Deena R, Verbov Gina, Edelstein Naomi, Stein-Zamir Chen
Jerusalem District Health Office - Ministry of Health, 86 Jaffa Road, 94341, Jerusalem, Israel.
The Hebrew University of Jerusalem, Faculty of Medicine, the Hebrew University and Hadassah Braun School of Public Health and Community Medicine, Ein Karem, PO Box 12272, 91120, Jerusalem, Israel.
Isr J Health Policy Res. 2019 Feb 7;8(1):23. doi: 10.1186/s13584-019-0287-7.
Pediatric preventive health services are delivered in many different formats throughout the world. In Israel, these services for young children are provided in designated Maternal Child Health Clinics (MCHC). The history and operation of Israel's MCHC have been described primarily in the Hebrew language medical literature with most of these reports being over a decade old. This paper provides an up to date summary of the evolution and current care in Israel's one-hundred-year old model for the provision of preschool preventive health services. As these clinics have been recognized by the World Organization as a model for emulation, it is important that such information be made available. Israel's MCHC provide universal care to infants and preschool children (0-6 years), free of charge. These community-based clinics provide developmental surveillance, growth monitoring, and routine childhood immunizations. Anticipatory guidance is offered to families on topics including nutrition, parenting and child safety. Screening is also performed for maternal postpartum depression and family violence. Care is given by public health nurses working in collaboration with physicians. The vast majority (> 96%) of the country's children receive care in this system. Immunization coverage rates through this system are in line with World Health Organization guidelines - over 95% overall average nationally. Unfortunately, the allocated funding has not increased in proportion to the population growth. There is ongoing debate on the role of the national government in health services: should it be that of a direct services provider or focus on guidance and regulation of the health system.
MCHC well child care can help assure widespread provision of pediatric preventive health care. For this model to function, both its funding and content needs to be updated on an ongoing basis to reflect current preventive health care needs.
儿科预防性保健服务在全球以多种不同形式提供。在以色列，针对幼儿的这些服务在指定的母婴健康诊所（MCHC）中提供。以色列母婴健康诊所的历史和运营情况主要在希伯来语医学文献中有所描述，其中大多数报告已有十多年历史。本文提供了以色列百年之久的学前预防性保健服务模式的发展及当前护理情况的最新总结。鉴于这些诊所已被世界组织认可为可效仿的模式，提供此类信息很重要。以色列的母婴健康诊所为婴儿和学龄前儿童（0至6岁）提供普遍免费护理。这些社区诊所提供发育监测、生长监测和常规儿童免疫接种。就营养、育儿和儿童安全等主题向家庭提供预期指导。还对产后母亲抑郁症和家庭暴力进行筛查。护理由与医生合作的公共卫生护士提供。该国绝大多数（>96%）儿童在这个系统中接受护理。通过这个系统的免疫接种覆盖率符合世界卫生组织的指导方针——全国总体平均超过95%。不幸的是，分配的资金没有与人口增长成比例增加。关于国家政府在卫生服务中的作用存在持续争论：它应该是直接服务提供者还是专注于卫生系统的指导和监管。
母婴健康诊所的儿童健康护理有助于确保广泛提供儿科预防性保健服务。为使该模式发挥作用，其资金和内容都需要持续更新，以反映当前的预防性保健需求。
