The 2017 survey revealed a number of areas linked to the European child and adolescent health strategy for which there is a need for better data collection. One such area is maternal alcohol consumption, for which data are collected by only one third of the countries, despite its high risk of harm for the health of the mother (13) and fetus (14). Prenatal alcohol exposure is a leading preventable cause of birth defects and neurodevelopmental abnormalities, and can cause a range of developmental, cognitive, and behavioural conditions that can appear at any time during childhood and may last a lifetime.
Mental health services for children and adolescents would also benefit from additional data collection that can support countries in planning and implementing programmes and policies relating to, for example, the number of prescriptions for children with mental and behavioural problems, for which many countries indicated that no data were collected (see also Chapter 8). More generally, disaggregated staffing levels by geographic area and information systems that separate out service provision for children and adolescents are areas that support improved national programming and for which additional investment is required (see also Chapter 4). The former is particularly low in EU Member States, with only seven EU countries reporting such data collection, while 15 countries in the CIS/SEEHN subregions report collecting data in this way.
These results should be interpreted with caution, since countries may have different mechanisms in place to ensure adequate provision across the country (through health insurance, for example).
AA-HA! (6) provides a sample list of indicators to monitor adolescent mental health programmes that could be useful as countries work to measure and evaluate this type of intervention. Lack of data on prescriptions is critical, since documenting this can help avoid the potential danger of overprescription of psychotropic drugs for young people, as well as underserving child and adolescent populations.
Conclusion
Most countries disaggregate their coverage data by sex, followed by geographic area, and migrant status. Improvements in disaggregation by socioeconomic background and ethnic background can support interventions that better address inequalities and help countries make children’s lives visible throughout their policy, programming and services. The 2017 survey showed a general need to collect data more systematically across a number of categories and highlighted a number of areas where efforts should be made to better document potential areas of neglect.
Table 3.1 includes all indicators used in this chapter, as well as data from the country profiles and the survey displayed by country with summary statistics.
Table 3.1. Collecting key data on all children: summary table
aMKD: the former Yugoslav Republic of Macedonia (MKD is an abbreviation of the ISO).
Table 3.1 contd
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Introduction
This chapter summarizes indicators related to health systems and quality of care for child and adolescent health, focusing on the evidence for strengthening people-centred health systems and increasing public health capacity to improve child and adolescent health and development. The indicators are those relevant to the European child and adolescent health strategy, especially to priority 2 on transforming the governance of child and adolescent health, with an emphasis on supporting growth during adolescence.
Key findings
● About half of the countries have mixed-care systems in which general practitioners (GPs) and paediatricians provide primary care for children; in 10 countries, it is only paediatricians.
● There is marked variability in staffing levels in health care for children and adolescents between urban and rural settings; half of the countries collect this information.
● A quarter of countries do not have a system in place to train health professionals in adolescent health.
● A third of countries do not perform regular perinatal death audits.
● Essential drugs lists and paediatric formulations for essential drugs are not widely available across the Region.
● About two thirds of countries have a policy to facilitate transition from paediatric to adult care to ensure the continuum of care.
Findings
Health systems in the Region have different care models (Fig. 4.1) and staffing levels (Fig. 4.2–4.4) to provide services for children and adolescents (an explanation of how the boxplot figures are presented is provided in Annex 1 (see also Fig. A1.5)).