Liu Mengyun, Woodman Jenny, Grath-Lone Louise Mc, Clery Amanda, Bunting Catherine, Bennett Samantha, Kendall Sally, Kirman Jennifer, Weatherly Helen, Barlow Jane, Bedford Helen, Harron Katie
UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.
Thomas Coram Research Unit, Social Research Institute, University College London, London, United Kingdom.
Int J Popul Data Sci. 2024 May 13;9(2):2382. doi: 10.23889/ijpds.v9i2.2382. eCollection 2024.
The health visiting service in England leads the government's Healthy Child Programme (HCP) for children under five years. Local authorities and their provider partners deliver this service differently across England.
To describe local authority variation in the delivery of health visiting to children under five years in England (2018-2020).
We used publicly available statistics on mandated health visiting contacts, and administrative data from the Community Services Dataset (CSDS) on duration, location, and medium of contacts. We mapped population coverage of mandated contacts (new birth visit, 6-8-week review, one-year review, and 2-2½ -year review) and described the frequency and characteristics of mandated and additional contacts across local authorities.
Based on publicly available data, almost all eligible children received their new birth visit, 6-8-week review and one-year review (89%-99%), with substantial variation across local authorities in children receiving the 2-2½ -year review: median 81%, range 33%-98%. Based on CSDS, 80% of local authorities (n=46/57) delivered more additional than mandated contacts: a median of 1.6 additional contacts (range: 0.1-8.5) were delivered for each mandated contact. There was also significant variation in the duration of contacts and the percentage of contacts delivered face-to-face and at home.
Despite decreases in funding and workforce since 2015, in 2018-2020, health visiting teams reached nearly all babies and most children face-to-face via mandated contacts, and conducted over one and a half times the number of additional contacts relative to mandated contacts, with variation between local areas. This represents a significant public health infrastructure to support the health and development of babies and children and the wellbeing of their families in the critical period before school. Our study highlights the importance of taking into account additional contacts. Further work is needed to understand variation, including in the way additional contacts are used.
英国的健康访视服务引领着政府针对五岁以下儿童的“健康儿童计划”（HCP）。地方当局及其服务提供伙伴在英国各地提供这项服务的方式有所不同。
描述英国地方当局在为五岁以下儿童提供健康访视服务方面的差异（2018 - 2020年）。
我们使用了关于法定健康访视接触的公开统计数据，以及来自社区服务数据集（CSDS）的关于接触时长、地点和方式的行政数据。我们绘制了法定接触（新生儿访视、6 - 8周复查、一岁复查和2 - 2.5岁复查）的人口覆盖率，并描述了各地方当局法定接触和额外接触的频率及特征。
根据公开数据，几乎所有符合条件的儿童都接受了新生儿访视、6 - 8周复查和一岁复查（89% - 99%），但在接受2 - 2.5岁复查的儿童中，各地方当局存在很大差异：中位数为81%，范围为33% - 98%。根据CSDS，80%的地方当局（n = 46/57）提供的额外接触多于法定接触：每一次法定接触的额外接触中位数为1.6次（范围：0.1 - 8.5次）。接触时长以及面对面和在家中进行接触的百分比也存在显著差异。
尽管自2015年以来资金和劳动力有所减少，但在2018 - 2020年期间，健康访视团队通过法定接触几乎与所有婴儿和大多数儿童进行了面对面接触，并且额外接触的次数是法定接触次数的一倍半以上，各地区之间存在差异。这是一个重要的公共卫生基础设施，可在入学前的关键时期支持婴儿和儿童的健康与发育以及其家庭的福祉。我们的研究强调了考虑额外接触的重要性。需要进一步开展工作以了解差异，包括额外接触的使用方式。
