Garg Pankaj, Eastwood John, Liaw Siaw-Teng
Department of Community Paediatrics, Liverpool Hospital, Liverpool, NSW, AU.
Specialist Disability Health Team, South Western Sydney Local Health District, NSW, AU.
Int J Integr Care. 2019 Jul 24;19(3):5. doi: 10.5334/ijic.4177.
Well-child Care is the provision of preventative health care services for children and their families. The approach, however, to the universal provision of those services is contentious.
We undertook a realist synthesis to enhance understanding of the theoretical mechanisms driving Well-child Care by searching for published and grey literature from multiple databases.
Well-child Care is re-conceptualised as an integrated program delivered in the continuum of pregnancy, infancy and childhood. Depending on the context, Well-child Care can be a policy, a strategy, or an actual clinical practice that promotes child and family health. The main mechanisms include: role, training and continuity of health providers; administrators' views of the return of investment on achieved outcomes; access to services by families; and the adaptation of programs to meet the dynamic needs of stakeholders. Evidence indicates that for most outcomes, Well-child Care is best delivered in partnerships between community health, social care, and early childhood education sectors.
We conclude that Well-child Care policy and program leaders should shift their focus to the integration of: human and physical resources; policy instruments; and shared agreement on outcomes measures across health, social and education sectors. In addition, countries should work towards strengthening universal early education programs and parents' health literacy regarding child development, health and safety.
儿童健康保健是为儿童及其家庭提供预防性医疗保健服务。然而，普遍提供这些服务的方式存在争议。
我们进行了一项现实主义综合研究，通过在多个数据库中搜索已发表和灰色文献，以增进对推动儿童健康保健的理论机制的理解。
儿童健康保健被重新概念化为一个在怀孕、婴儿期和儿童期连续过程中提供的综合项目。根据具体情况，儿童健康保健可以是一项政策、一种策略或一种促进儿童和家庭健康的实际临床实践。主要机制包括：卫生保健提供者的角色、培训和连续性；管理人员对已取得成果的投资回报的看法；家庭获得服务的机会；以及项目的调整以满足利益相关者的动态需求。证据表明，对于大多数成果而言，儿童健康保健最好由社区卫生、社会护理和幼儿教育部门之间的伙伴关系来提供。
我们得出结论，儿童健康保健政策和项目领导者应将重点转向整合：人力和物力资源；政策工具；以及卫生、社会和教育部门对成果衡量标准的共同认可。此外，各国应努力加强普及早期教育项目以及提高家长在儿童发育、健康和安全方面的健康素养。
