Departement of Biomedical sciences, Neuroscience Institute, National Research Council, Padova, Italy.
Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy.
Eur J Public Health. 2021 Oct 11;31(4):679-687. doi: 10.1093/eurpub/ckab086.
The evaluation of child healthcare is not yet widely explored, especially from a cross-country comparison perspective. The routine adoption of measures by national assessment agencies is under-investigated. Though the guiding principles developed at international level call for a child-centric multi-dimensional evaluation of child care, its feasibility is hampered by the availability of robust and harmonized data.
To explore the data availability, international databases (IDBs) were scrutinized and measures dealing with child health-related issues were collated. In parallel, an ad hoc questionnaire was administrated to 30 Country Agents (CAs) to gather measures routinely adopted at local level. To facilitate the comparison of measures, a three-level conceptual map was developed.
The IDBs yielded at 207 measures that pertained mainly to non-health determinants of health, whereas the 352 measures obtained from CAs focused on process and outcome. A set of 33 common measures that related to immunization, morbidity and mortality were identified.
A limited set of measures used both in IDBs and at national level identify common areas of concerns that certainly capture crucial issues with child prevention and health outcomes. However, they are far from satisfying a child-centric multi-dimensional approach to the evaluation of child well-being and well-becoming. There is room for improvement at both international and national levels. IDBs should include and harmonize measures that concern the provision of child-centric services and encompass physical, social and mental development. At the national level, efforts towards the inclusion of measures that concern non-health determinants of health should be pursued.
儿童保健评估尚未得到广泛探索，特别是从跨国比较的角度来看。国家评估机构常规采用的措施也没有得到充分研究。尽管国际层面制定的指导原则呼吁采用以儿童为中心的多维儿童保健评估方法，但由于缺乏强大和协调一致的数据，其可行性受到阻碍。
为了探索数据的可用性，对国际数据库（IDB）进行了仔细检查，并整理了与儿童健康相关问题有关的措施。同时，向 30 个国家代理（CA）专门发送了一份问卷，以收集在当地层面常规采用的措施。为了便于措施的比较，开发了一个三级概念图。
IDB 产生了 207 项措施，主要涉及健康的非健康决定因素，而从 CAs 获得的 352 项措施则侧重于过程和结果。确定了一组 33 项共同措施，这些措施与免疫、发病率和死亡率有关。
IDB 和国家层面都使用的有限数量的措施确定了共同关注的领域，这些领域肯定涉及儿童预防和健康结果的关键问题。然而，它们远远不能满足以儿童为中心的多维方法来评估儿童的幸福和成长。在国际和国家层面都有改进的空间。IDB 应纳入并协调关注提供以儿童为中心的服务的措施，并涵盖身体、社会和心理健康发展。在国家层面，应努力纳入与健康决定因素无关的措施。
