Collection of data that enable countries to support national surveillance and cross-national comparisons should be a priority for countries in the Region. Such data are crucial to developing targeted action and monitoring progress. There are at least two areas (obesity and soft-drink consumption) in which increased participation in regional efforts can enable Member States to secure better data. Surveys such as USAID’s DHS (17) and UNICEF’s MICS (18) provide systematic population-based information on complementary feeding practices and nutritional status for children under 5. Countries that do not participate in these surveys must develop comparable means of collecting such data.
Countries should also consider looking at laws and regulations that can positively affect behaviours across the Region around, for example, breastfeeding, complementary feeding and marketing to children. Increased health literacy and health promotion for children and adolescents could support increased knowledge about the benefit of toothbrushing in preventing NCDs and strengthen efforts to design more effective interventions to increase physical activity and promote healthier lifestyles (19) among children and adolescents.
Conclusion
Exclusive breastfeeding rates remain embarrassingly low in the Region. Having a policy in place is insufficient to improve breastfeeding rates on its own. Reporting according to internationally accepted standards must be addressed to increase data quality, but this needs to lead to improved action.
There is major room for improvement in collecting data about the marketing of complementary feeding products. Marketing is often misleading and needs to be documented to prevent increasing consumption of foods with excessive sugar, salt or fats.
Surveillance and monitoring of children under 5 affected by obesity is lacking, with pervasive inconsistency in methods and collection. For older children, COSI and HBSC surveys show an increasing overnutrition problem. Countries need to consider adoption and enforcement of laws and regulations that can positively affect behaviours to, for example, promote breastfeeding, ban marketing to children and take health promotion in schools seriously.
Table 10.1 includes all indicators used in this chapter, and data from the country profiles and the survey displayed by country with summary statistics.
Table 10.1. Nutrition and physical activity: summary table
Country
Having a breastfeeding policy Collecting breastfeeding data Collecting soft-drink data Having regulations that restrict marketing to children Collecting data on complementary feeding Collecting data on the marketing of complementary feeding products Collecting data on the prevalence of overweight/ obesity under 5 years Breastfeeding within 1 hour after birth (%) Breastfeeding <6 months (%) Exclusive breastfeeding up to 6 months (%) Country code
Albania – – – – – – – 43 72 39 ALB
aMKD: the former Yugoslav Republic of Macedonia (MKD is an abbreviation of the ISO).
Table 10.1 contd
Obesity/overweight, girls 15 (%) Obesity/overweight, boys 15 (%) Overweight, boys 6–9 (%) Overweight, girls 6–9 (%) Soft-drink consumption, boys 15 (%) Soft-drink consumption, girls 15 (%) MVPA, boys 15 MVPA, girls 15 Insufficiently active 11–17 years (%) girls Insufficiently active 11–17 years (%) boys Stunting under 5 years (%) Wasting under 5 years (%) Brushing teeth, girls 15 (%) Brushing teeth, boys 15 (%) Country code
Country
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Introduction
This chapter describes country-level indicators that are included in the online country profiles (1) and others extracted from additional data sources. They give a perspective on the political, social and governmental context of children’s lives in Europe. The chapter summarizes the relationship between indicators emphasized by the SDGs (2) and the WHO European child and adolescent health strategy (3), such as child mortality and adolescent pregnancy rates, and their relation to indicators describing the social and political environments in which children live. These social and political factors are determinants of child health, as recognized by the European policy framework, Health 2020 (4).
Details on the analysis performed for this chapter can be found in Annex 1.
Key findings
● Child mortality has decreased considerably in the European Region.
● Child mortality and adolescent pregnancy rates vary widely; they are correlated with the country’s GDP.
● There is a strong correlation between governance indicators and under-5 mortality and adolescent pregnancy rates. The Corruption Perceptions Index shows the strongest correlation with under-5 mortality.