This paper is a provisional report from an ongoing field experiment in Uppsala, Sweden, with the aim to reduce the number of serious childhood accidents. Groups of parents have been systematically trained to function as child-environment supervisors. The experiences have been very positive so far. The child-environment supervisors have proved to possess good knowledge about how to prevent accidents. A large number of hazards have been detected and successfully eliminated. The groups are now taking an active part in the planning of new housing estates. The findings also indicate that the Child Health Organization should be able to play a more active role in the work of environmental improvement for the safety of children. A suggestion for a collective strategy for such activity has been worked out.
Objective evaluations of population's health belong to the most important tasks of the public-health science. Such evaluations made in respect to children are of extra importance. One must comprehensively understand the potentialities and abilities of the methods used for the purpose. A comparative evaluation of 387 children, aged 10, was based on the findings of medical check-ups and on questionnaires of their parents. 37.7% of children, who were evaluated by their mothers as having good health, were diagnosed by doctors as having a chronic disease, i.e. the diagnosis did not entail any life limitations for such children. 40% of those children, who were referred to by their parents as sick (poor health), were classified by doctors as belonging not to category 3 (chronic pathology) but to a category of healthier children (category 2). Below 10% of children, who were describe by their parents as having poor health, were among those who were put by doctors on the list of group 3 on the basis of medical check-ups. As for those children who had an actively displayed chronic disease with a pronounced clinical course, like bronchial asthma, ulcer etc., the opinions of doctors and of their parents coincided in a majority of cases. The comparative evaluations of children' health based on questionnaires of their parents and on medical check-ups exposed a certain coincidence and specificity of such evaluations since they are based on different approaches.
OBJECTIVE: To study factors of importance for infants' use of health and medical care. DESIGN: We studied the medical records of the mother during pregnancy (at the health centre, at the antenatal clinics, and at the department of obstetrics and gynaecology) and of her infant during the first 18 months of life (at the health centre, at the child health clinic, and at the departments of paediatrics and oto-rhino-laryngology). We also interviewed the mother when her infant was 18 months old. SETTING: Teleborg health centre, Växjö, southern Sweden. SUBJECTS: 206 infants and their mothers. MAIN OUTCOME MEASURES: Medical visits, to doctor or district nurse, during the infants' first 18 months of life, and factors of potential importance for those visits. RESULTS: A stepwise linear multiple regression analysis showed that the following factors were of importance for the infant's use of health and medical care: number of mother's visits to the health and medical services during pregnancy, mother being a primipara, and mother being a blue-collar worker. The model (12.98 + 0.52* (no. of mother's visits) + 2.19 (if primipara) + 1.48 (if blue-collar worker)) was able to explain 8.6% of the number of infant's visits. CONCLUSION: The studied factors explained only a minor part of the infants' use of health and medical care.
The aim of this study was to evaluate some aspects of care given within the preventive Child Health Services (CHS) during the first 18 months of life. A national random sample performed on child health records of 172 Swedish preschool children born between 1982 and 1987 was analysed regarding services recorded as having been provided and used within and beyond the national programme of health surveillance. Most families had made visits within the core programme of health surveillance to an optimal or at least sufficient extent. First-time parents visited the CHS more frequently than did more experienced parents. Procedures within the programme, such as growth monitoring, hip examination and immunizations, were documented to have been optimally performed on a majority of the children. Conversely, screening for hearing impairment and assessment of developmental milestones were performed less frequently, as were health information and postnatal parental education. To improve the quality of care, national recommendations ought to be more specific regarding both the performance and the documentation of the service.
To obtain baseline data on the health status and use of health services of children exposed to violence in their families.
The study used data from the first cycle of the National Longitudinal Survey of Children and Youth (1994/95). According to parental reports, 8.6% of children (n = 1,648; representing 329,657 children) aged 2 to 11 years witnessed some violence in their families. They were compared to children who were reported to have never witnessed any violence at home.
Children exposed to domestic violence had lower health status and more conditions or health problems which limited their participation in normal age-related activities than children in non-violent families. Despite this, they had no more contacts with family practitioners in the previous year and even fewer contacts with pediatricians than comparison children. They did, however, have more contacts with "other medical doctors," public health nurses, child welfare workers, and other therapists than comparison children. In addition, more child witnesses regularly used prescription medication than children not exposed to violence at home.
These baseline findings suggest that exposure to domestic violence has an adverse impact on children's health and use of health services. As future cycles become available, these children will be followed to determine the long-term impact on these outcomes.