Kadir Ayesha, Stevens Amy J, Takahashi Emi A, Lal Sham
Save the Children International, London, United Kingdom.
Yorkshire and Humber School of Public Health, Leeds, United Kingdom.
PLOS Glob Public Health. 2025 Mar 14;5(3):e0003843. doi: 10.1371/journal.pgph.0003843. eCollection 2025.
Children and young people are disproportionately vulnerable to harm during crises, yet child public health expertise is limited in humanitarian settings and outcomes and impact data are lacking. This review characterises child public health indicators that are routinely collected, required by donors, and recommended for use in fragile, conflict-affected, and vulnerable (FCV) settings. We conducted database and grey literature searches and collected indicators from technical agencies, partnerships, donors, and nongovernmental organisations providing child public health services in FCV settings. Indicators were included if they were child-specific or disaggregated for ≤18 years. Indicators were coded into domains of health status, health service, social determinants, and health behaviours and analysed for trends in thematic focus and clarity. A total of 668 indicators were included. Routinely collected indicators (N = 152) focused on health status and health services. Donors required only 14 indicators. Technical bodies and academics recommended 502 indicators for routine measurement. Prioritised topics included nutrition, paediatrics, infectious diseases, mortality, and maternal-newborn care. There were notable gaps in indicators for child development and disability. Child protection indicators were not routinely collected, despite being the focus of 39% of recommended indicators. There were overlaps and duplications, varied age disaggregations, and 49% of indicators required interpretation to measure. The review demonstrates that it is feasible to routinely measure child public health outcomes in FCV settings. Recommendations from technical agencies and partnerships are characterised by numerous indicators with duplication, poor definitions, and siloed sector-specific focus. There are gaps in measurement of critical child public health topics. To improve safety and effectiveness of interventions for child public health, consensus is needed on priority topics and a shortlist of quality, standardised indicators that governmental and nongovernmental actors can be reasonably expected to measure. Indicators should be prioritised to support decision-making and include proxy indicators for periods when routine measurement is hampered.
儿童和年轻人在危机期间特别容易受到伤害，但在人道主义环境中儿童公共卫生专业知识有限，且缺乏成果和影响数据。本综述描述了在脆弱、受冲突影响和易受伤害（FCV）环境中常规收集、捐助方要求以及建议使用的儿童公共卫生指标。我们进行了数据库和灰色文献检索，并从在FCV环境中提供儿童公共卫生服务的技术机构、伙伴关系、捐助方和非政府组织收集指标。如果指标是针对儿童的或按≤18岁进行分类，则予以纳入。指标被编码为健康状况、卫生服务、社会决定因素和健康行为领域，并分析其主题重点和清晰度的趋势。共纳入668项指标。常规收集的指标（N = 152）侧重于健康状况和卫生服务。捐助方仅要求14项指标。技术机构和学者建议对502项指标进行常规测量。优先主题包括营养、儿科学、传染病、死亡率和孕产妇-新生儿护理。儿童发育和残疾指标存在明显差距。尽管儿童保护指标占建议指标的39%，但并未常规收集。存在重叠和重复、年龄分类各异的情况，且49%的指标需要解释才能进行测量。该综述表明，在FCV环境中常规测量儿童公共卫生成果是可行的。技术机构和伙伴关系的建议具有指标众多、重复、定义不佳以及部门特定重点孤立等特点。关键儿童公共卫生主题的测量存在差距。为提高儿童公共卫生干预措施的安全性和有效性，需要就优先主题以及政府和非政府行为体有望合理测量的高质量、标准化指标清单达成共识。应优先考虑指标以支持决策，并包括在常规测量受阻期间的替代指标。
