Child Health, Health Services and Systems in UK and other European countries

Abstract: BackgroundThis work in child population medicine describes child health problems, increases knowledge of health services, systems, and wider determinants, and makes recommendations for improvements.AimsTo explore trends in UK child health and health service quality and highlight policy lessons from the UK and other European countriesTo study child health and health services in western Europe and derive lessons from different approaches to common challengesTo enhance knowledge on child to adult transition careTo describe trends in UK and EU15+ child and adolescent mortality and seek explanations for deteriorating UK health system performance, and make recommendations for improving survivalMethodsPopulation level measures of health status and system performance; primary and secondary research on policies and practice for health system assessments. Quantitative: mortality rate trends, excess deaths, DALYs, healthcare processes Qualitative: case reports, system descriptions, analyses ResultsEuropean child survival has improved, but variably between countries. The UK has not matched recent EU mortality gains. There are 6,000 excess deaths annually in children under 15 years in EU14 countries. There are child survival inequities; countries investing in social protection have lower mortality. Children in the UK, compared with other EU countries, are more likely to be poor than adults.Non-communicable diseases are now dominant causes of child death, disease, and disability.Mortality, processes, and outcomes of healthcare amenable conditions varies between countries. Better outcomes seem to be associated with flexible health care models promoting cooperation, team working, and transition.ConclusionsChild health in Europe is improving, but unevenly. Child health systems are not adapting sufficiently to meet needs. Recommendations are made for improving health systems and services.