Requejo Jennifer, Strong Kathleen, Agweyu Ambrose, Billah Sk Masum, Boschi-Pinto Cynthia, Horiuchi Sayaka, Jamaluddine Zeina, Lazzerini Marzia, Maiga Abdoulaye, McKerrow Neil, Munos Melinda, Park Lois, Schellenberg Joanna, Weigel Ralf
Division of Data, Analytics, Planning and Monitoring, United Nations Children's Fund, New York, NY, USA.
Maternal, Newborn, Child and Adolescent Health and Aging Department, World Health Organization, Geneva, Switzerland.
Lancet Child Adolesc Health. 2022 May;6(5):345-352. doi: 10.1016/S2352-4642(22)00039-6.
Although great improvements in child survival were achieved in the past two decades, progress has been uneven within and across countries, and the COVID-19 pandemic threatens to reverse previous advances. Demographic and epidemiological transitions around the world have resulted in shifts in the causes and distribution of child death and diseases, and many children are living with short-term and long-term chronic illnesses and disabilities. These changes, plus global threats such as pandemics, transnational and national security issues, and climate change, mean that regular monitoring of child health and wellbeing is essential if we are to achieve the Sustainable Development Goals. This Health Policy describes the three-phased process undertaken by the Child Health Accountability Tracking technical advisory group (CHAT) to develop a core set of indicators on child health and wellbeing for global monitoring purposes, and presents CHAT's research recommendations to address data gaps. CHAT reached consensus on 20 core indicators specific to the health sector, which include 11 impact-level indicators and nine outcome-level indicators that cover the topics of: acute conditions and prevention; health promotion and child development; and chronic conditions, disabilities, injuries, and violence against children. An additional six indicators (three impact and three outcome) that capture information on child health issues such as malaria and HIV are recommended; however, these indicators are only relevant to high-burden regions. CHAT's four research priorities will require investments in health information systems and measurement activities. These investments will help to increase data on children aged 5-9 years; develop standard metadata and data collection processes to enable cross-country comparisons and progress assessments over time; reach a global consensus on essential interventions and associated indicators for monitoring emerging priority areas such as child development, chronic conditions, disabilities, and injuries; and implement strategies to increase the uptake of data on child health to improve evidence-based planning, programming, and advocacy efforts.
尽管在过去二十年里儿童生存率有了很大提高，但各国国内及各国之间的进展并不均衡，而且新冠疫情可能会使之前取得的进展发生逆转。世界各地的人口和流行病学转变导致了儿童死亡和疾病的原因及分布发生变化，许多儿童患有短期和长期的慢性病及残疾。这些变化，再加上大流行、跨国和国家安全问题以及气候变化等全球威胁，意味着如果我们要实现可持续发展目标，定期监测儿童健康和福祉至关重要。本卫生政策描述了儿童健康问责追踪技术咨询小组（CHAT）为制定一套用于全球监测的儿童健康和福祉核心指标而开展的三阶段过程，并提出了CHAT关于解决数据差距的研究建议。CHAT就卫生部门特有的20项核心指标达成了共识，其中包括11项影响层面指标和9项结果层面指标，涵盖以下主题：急性病症与预防；健康促进与儿童发育；慢性病、残疾、伤害以及针对儿童的暴力行为。还建议增加6项指标（3项影响指标和3项结果指标），用于获取有关疟疾和艾滋病毒等儿童健康问题的信息；不过，这些指标仅与高负担地区相关。CHAT的四项研究重点需要对卫生信息系统和测量活动进行投资。这些投资将有助于增加5至9岁儿童的数据；制定标准元数据和数据收集流程，以便能够进行跨国比较并随时间推移进行进展评估；就监测儿童发育、慢性病、残疾和伤害等新出现的优先领域的基本干预措施及相关指标达成全球共识；并实施各项战略，以提高儿童健康数据的使用率，从而改进基于证据的规划、方案制定和宣传工作。
