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Moving from a universal to targeted child health programme: which children receive enhanced care? A population-based
1Information Services Division, NHS National Services Scotland, Edinburgh, UK.
Child: Care, Health and Development
|August 16, 2012
Summary
Identifying children for enhanced health support involves many factors, including socioeconomic status and maternal health. Area-level variations in support allocation require further investigation.
Area of Science:
- Child Health
- Public Health
- Health Services Research
Background:
- UK child health programme delivery emphasizes progressive universalism, with enhanced support based on need.
- Scotland utilizes the Health Plan Indicator (HPI) to identify children needing additional child health programme support.
Purpose of the Study:
- To explore factors associated with identifying children requiring enhanced support within the Scottish child health programme.
- To analyze the influence of various child, maternal, and area-level factors on enhanced support allocation.
Main Methods:
- Utilized routine child health programme and hospital delivery records for 36,871 Scottish children.
- Employed multilevel logistic regression modelling to identify factors associated with enhanced support assessment.
Main Results:
- Deprivation, young maternal age, maternal smoking/drug misuse, previous stillbirth, prematurity, small for gestational age, no breastfeeding, special care unit admission, and infant medical/social/developmental concerns were linked to increased support needs.
- Higher Health Visitor staffing levels showed a non-significant trend towards increased assessment for enhanced support.
- Significant unexplained variation in enhanced support assessment existed between geographical areas.
Conclusions:
- Health Visitors consider a complex interplay of factors when assessing children for enhanced support.
- Potential influence of Health Visitor workload on assessment requires further study.
- Disparities in HPI category allocation across areas necessitate further research into care provision and child outcomes.
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