Casáis-Suárez Yara, Llosa José Antonio, Menéndez-Espina Sara, Fernández-Méndez Alba, Prieto-Saborit José Antonio, Jiménez-Arberas Estíbaliz
Faculty Padre Ossó, University of Oviedo, 33008 Oviedo, Spain.
Children (Basel). 2025 Aug 17;12(8):1079. doi: 10.3390/children12081079.
Diverse realities challenge the management capacity of public and private systems to ensure equitable quality and efficient access to resources, in line with the 2030 Agenda and the Sustainable Development Goals, which aim to close gaps in essential services and ensure quality of life. The reality in Spain, and more specifically in the Principality of Asturias, is that most resources are concentrated in urban areas rather than rural ones, partly due to the region's geography. : This study aimed to explore the perspectives of various stakeholders on the early childhood care system in the Principality of Asturias (Spain), with the purpose of analyzing the mechanisms and determinants involved in its functioning and identifying opportunities for improvement. : A qualitative study was conducted using the theoretical framework of the National Institute on Minority Health and Health Disparities (NIMHD) as a conceptual basis. Semi-structured interviews were carried out with 24 participants selected based on their relationship with early childhood care systems, encompassing different levels of responsibility and operational roles. Data were analyzed using a phenomenological approach, employing inductive and deductive coding to identify recurring patterns and code co-occurrences within ATLAS.ti software. : This study reveals major barriers to equitable early childhood intervention (ECI) in rural areas, such as geographic isolation, lack of specialists, long waiting times, and poor transport. Six key themes emerged, including the need for standardized system management, better family support, and digital tools like centralized electronic health records. Rural areas are directly limited regarding their access to services, highlighting the need for fair territorial planning and a holistic, inclusive care model. Improving coordination, accessibility, and technology is vital.
各种现实情况对公共和私营系统的管理能力构成挑战，这些系统需要根据2030年议程和可持续发展目标，确保公平、高质量和高效地获取资源，这些目标旨在缩小基本服务差距并确保生活质量。西班牙的实际情况，更具体地说是阿斯图里亚斯公国的情况是，大多数资源集中在城市地区而非农村地区，部分原因是该地区的地理环境。本研究旨在探讨西班牙阿斯图里亚斯公国各种利益相关者对幼儿护理系统的看法，目的是分析其运作中涉及的机制和决定因素，并确定改进机会。本研究采用美国国立少数族裔健康与健康差异研究所（NIMHD）的理论框架作为概念基础，进行了一项定性研究。根据与幼儿护理系统的关系，选取了24名参与者进行半结构化访谈，这些参与者涵盖了不同的责任级别和运营角色。使用现象学方法对数据进行分析，采用归纳和演绎编码，在ATLAS.ti软件中识别重复出现的模式和编码共现情况。本研究揭示了农村地区公平幼儿干预（ECI）的主要障碍，如地理隔离、缺乏专业人员、等待时间长和交通不便。出现了六个关键主题，包括需要标准化的系统管理、更好的家庭支持以及诸如集中式电子健康记录等数字工具。农村地区在获取服务方面受到直接限制，这凸显了公平领土规划和全面、包容性护理模式的必要性。改善协调、可及性和技术至关重要。
