Issues and Opportunities in Primary Health Care for Children in Europe最新文献

National and Public Cultures as Determinants of Health Policy and Production 国家和公共文化作为卫生政策和生产的决定因素

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191005

K. Zdunek, M. Blair, D. Alexander

{"title":"National and Public Cultures as Determinants of Health Policy and Production","authors":"K. Zdunek, M. Blair, D. Alexander","doi":"10.1108/978-1-78973-351-820191005","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191005","url":null,"abstract":"The Models of Child Health Appraised (MOCHA) project recognises that child health policy is determined to a great extent by national culture; thus, exploring and understanding the cultural influences on national policies are essential to fully appraise the models of primary care. Cultures are created by the population who adopt national rituals, beliefs and code systems and are unique to each country. To understand the effects of culture on public policy, and the resulting primary care services, we explored the socio-cultural background of four components of policy-making: content, actors, contexts and processes. Responses from the MOCHA Country Agents about recent key national concerns and debates about child health and policy were analysed to identify the key factors as determinants of policy. These included awareness, contextual change, freedom, history, lifestyle, religion, societal activation and tolerance. To understand the influence of these factors on policy, we identified important internal and external structural determinants, which we grouped into those identified within the structure of health care policy (internal), and those which are only indirectly correlated with the policy environment (external). An important child-focused cultural determinant of policy is the national attitude to child abuse. We focused on the role of primary care in preventing and identifying abuse of children and young people, and treating its consequences, which can last a lifetime.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115039206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Bringing MOCHA Lessons to Your Service 将摩卡课程带到您的服务中

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191006

Magda Boere-Boonekamp, K. Groothuis-Oudshoorn, T. Schloemer, P. Schröder-Bäck, Janine van Til, K. Zdunek, P. Kocken

{"title":"Bringing MOCHA Lessons to Your Service","authors":"Magda Boere-Boonekamp, K. Groothuis-Oudshoorn, T. Schloemer, P. Schröder-Bäck, Janine van Til, K. Zdunek, P. Kocken","doi":"10.1108/978-1-78973-351-820191006","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191006","url":null,"abstract":"Identifying the qualities of primary care that have the potential to produce optimal health outcomes is only half the story. The MOCHA project has explored how to transfer these to other national contexts, but also which successful components should be transferred. It is important to assess the population criteria of the identified sociodemographic, cultural and social characteristics, and the population perspectives on a care system’s components. The project analysed public experiences and perceptions of the quality of primary care for children from a representative sample of the general public in five EU Member States. The public perception of children’s primary care services, in particular the perceived quality of care and expectations of children and their care is important to understand before MOCHA lessons can be effectively adopted in a country. We found that the socio-cultural characteristics of a country inform the population perceptions and preferences with regard to the care system. In the five countries surveyed there was agreement about aspects of quality of care – such as accessible opening hours, confidential consultations for children and timeliness of consultation for an illness; but there was a difference in opinion about giving priority to items such as making an appointment without a referral, or a child’s right to a confidential consultation. The cultural context of transferability and the means of addressing this such as defining the target audience and the different means of disseminating important messages to the wider community to address contextual factors can act as barriers or facilitators to the introduction of new components of primary care models.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130262689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Evidence to Achieve an Optimal Model for Children’s Health in Europe 实现欧洲儿童健康最佳模式的证据

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191004

M. Blair, M. Rigby, D. Alexander

{"title":"Evidence to Achieve an Optimal Model for Children’s Health in Europe","authors":"M. Blair, M. Rigby, D. Alexander","doi":"10.1108/978-1-78973-351-820191004","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191004","url":null,"abstract":"Abstract \u0000Models of Child Health Appraised (MOCHA) was a wide-ranging, multi-disciplinary and multi-method study that aimed to identify the best models of provision of primary care for the children of the European Union. The research has identified two main conclusions: (1) The depth of interdependency of health, economy and society. Primary care needs to be an active partner in public debate about current child health concerns. It should orientate more effectively in addressing wider societal influences on child health through advocacy and collaborative intersectoral public health approaches with those agencies responsible for public and community health if it is to address effectively issues such as childhood obesity, mental health and vaccine hesitancy. As part of this, it needs to address its workforce composition and skills, not least in two-way communication. (2) The European Community has many visions and commitments to children and child health policies, but their effectiveness is largely unfulfilled. The Commission can strengthen its impact on children’s health and healthcare services within current remits and resources by focusing on a number of key fields: planned and structured research, providing insight into optimal human resources and skills in child primary care, developing and using ethical means of listening to children’s views, remedying the invisibility of children in data, measuring the quality of primary care from a child-centric perspective, understanding the economics of investing in children’s health, developing e-health standards and evaluation, collaborative and harmonised use of downloaded research databases, understanding and respecting children’s rights and equity, and appreciating and allowing for children’s evolving autonomy as they grow up. An optimal model of primary care for children is proactive, inclusive, corporately linked, based on and providing robust evidence, and respects the wider determinants of health and children’s involvement in their health trajectory.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121228790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

e-Health as the Enabler of Primary Care for Children 电子保健是儿童初级保健的推动者

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191017

M. Rigby, G. Kühne, S. Deshpande

{"title":"e-Health as the Enabler of Primary Care for Children","authors":"M. Rigby, G. Kühne, S. Deshpande","doi":"10.1108/978-1-78973-351-820191017","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191017","url":null,"abstract":"Abstract \u0000Information and communication technologies can transform how services can be and are delivered as has already happened in other arenas, such as civil aviation, financial services and retailing. Most modern health care is heavily dependent on e-health, including record keeping, targeted information sharing and digital diagnostic and imaging techniques. However, there remains little scientific knowledge base for optimal system content and function in primary health care, particularly for children. Models of Child Health Appraised (MOCHA) aimed to establish the current e-health situation in children’s primary care services. Electronic health records (EHRs) are in regular use in much of northern and western Europe and in some newer European Union Member States, but other countries lag behind. MOCHA investigated the use of unique identifiers, the use of case-based public health EHRs and the capability of record linkage, linkage of information with school health data and monitoring of social media influences, such as health websites and health apps. A widespread lack of standards underlined a lack of research enquiry into this issue in terms of children’s health data and health knowledge. Health websites and apps are a growing area of healthcare delivery, but there is a worrying lack of safeguards in place. The challenge for policy-makers and practitioners is to be aware and to lead on the innovative harnessing of new technologies, while protecting child users against new harms.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"28 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113941490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The MOCHA Project: Origins, Approach and Methods 摩卡项目:起源、途径和方法

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191001

M. Blair, D. Alexander, M. Rigby

{"title":"The MOCHA Project: Origins, Approach and Methods","authors":"M. Blair, D. Alexander, M. Rigby","doi":"10.1108/978-1-78973-351-820191001","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191001","url":null,"abstract":"Primary care (PC) is a strong determinant of overall health care. Children make up around a fifth of the population of the European Union and European Economic Area and have their own needs and uptake of PC. However, there is little research into how well PC services address their needs. There are large differences in childhood mortality and morbidity patterns in the EU and EEA countries, and there has been a major epidemiological shift in the past half century from predominantly communicable disease, to non-communicable diseases presenting and increasingly managed in PC. This increase in multifactorial morbidities, such as obesity and learning disability, has led to the need for PC systems to adapt to accommodate these changes. Europe presents a challenging picture of unexplained variation in health care delivery and style and of children’s different health experiences and health-related behaviour. The Models of Child Health Appraised (MOCHA) project aimed to describe the PC systems in detail, analyse their components and appraise them from a number of different viewpoints, including professional, public, political and economic lenses. It did this through nine work packages supported by a core management team, and a network of national agents, individuals in each MOCHA country who had the expertise in research and knowledge of their national health care system to answer a wide range of questions posed by the MOCHA scientific teams.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129279725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Models of Primary Care and Appraisal Frameworks 初级保健模式和评估框架

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191007

M. Blair, M. Sampaio, M. Rigby, D. Alexander

{"title":"Models of Primary Care and Appraisal Frameworks","authors":"M. Blair, M. Sampaio, M. Rigby, D. Alexander","doi":"10.1108/978-1-78973-351-820191007","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191007","url":null,"abstract":"Abstract \u0000The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130326387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Appendix 2: List of MOCHA Country Agents 附录2:MOCHA国家代理商名单

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191023

引用次数: 0

The Invisibility of Children in Data Systems 数据系统中儿童的不可见性

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191011

M. Rigby, S. Deshpande, D. Luzi, F. Pecoraro, Oscar Tamburis, I. Rocco, Barbara Corso, Nadia Mimnicuci, H. Liyanage, U. Hoang, F. Ferreira, S. Lusignan, Ekelechi MacPepple, H. Gage

{"title":"The Invisibility of Children in Data Systems","authors":"M. Rigby, S. Deshpande, D. Luzi, F. Pecoraro, Oscar Tamburis, I. Rocco, Barbara Corso, Nadia Mimnicuci, H. Liyanage, U. Hoang, F. Ferreira, S. Lusignan, Ekelechi MacPepple, H. Gage","doi":"10.1108/978-1-78973-351-820191011","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191011","url":null,"abstract":"In order to assess the state of health of Europe’s children, or to appraise the systems and models of healthcare delivery, data about children are essential, with as much precision and accuracy as possible by small group characteristic. Unfortunately, the experience of the Models of Child Health Appraised (MOCHA) project and its scientists shows that this ideal is seldom met, and thus the accuracy of appraisal or planning work is compromised. In the project, we explored the data collected on children by a number of databases used in Europe and globally, to find that although the four quinquennial age bands are common, it is impossible to represent children aged 0–17 years as a legally defined group in statistical analysis. Adolescents, in particular, are the most invisible age group despite this being a time of life when they are rapidly changing and facing increasing challenges. In terms of measurement and monitoring, there is little progress from work of nearly two decades ago that recommended an information system, and no focus on the creation of a policy and ethical framework to allow collaborative analysis of the rich anonymised databases that hold real-world people-based data. In respect of data systems and surveillance, nearly all systems in European society pay lip service to the importance of children, but do not accommodate them in a practical and statistical sense.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131235744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

The Limited Inclusion of Children in Health and Health-related Policy 儿童在卫生和卫生相关政策中的有限参与

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191010

M. Blair, M. Rigby, Arjun Menon, M. Mahgerefteh, G. Kühne, S. Deshpande

引用次数: 1

School Health Services 学校卫生服务

Issues and Opportunities in Primary Health Care for Children in Europe Pub Date : 2019-05-06 DOI: 10.1108/978-1-78973-351-820191015

D. Jansen, Johanna P. M. Vervoort, A. Visser, S. Reijneveld, P. Kocken, Gaby de Lijster, P. Michaud

{"title":"School Health Services","authors":"D. Jansen, Johanna P. M. Vervoort, A. Visser, S. Reijneveld, P. Kocken, Gaby de Lijster, P. Michaud","doi":"10.1108/978-1-78973-351-820191015","DOIUrl":"https://doi.org/10.1108/978-1-78973-351-820191015","url":null,"abstract":"MOCHA defines school health services as those that exist due to a formal arrangement between educational institutions and primary health care. School health services are unique in that they are designed exclusively to address the needs of children and adolescents in this age group and setting. We investigated school health services have been provided to schools, and how they contribute to primary health care services for school children. We did this by mapping the national school health systems against the standards of the World Health Organization, and against a framework measuring the strength of primary care, adapting this from an existing, adult-focused framework. We found that all but two countries in the EU and EEA have school health services. There, however, remains a need for much greater investment in the professional workforce to run the services, including training to ensure appropriateness and acceptability to young people. Greater collaboration between school health services and primary care services would lead to better coordination, and the potential for better health (and educational) outcomes. Involving young people and families in the design of school health services and as participants in its outputs would also improve school health.","PeriodicalId":373125,"journal":{"name":"Issues and Opportunities in Primary Health Care for Children in Europe","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122967993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1