Development of a child health indicator system in Italy.

Abstract

The need for a uniform, comprehensive and action-oriented child health indicator system is widely recognised. As part of a Ministry of Health project, a working group was established in Italy in order to develop a proposal for a minimum set of health indicators to be adopted at the regional and local health authority levels, where the planning process takes place. The indicators proposed cover 17 areas of perinatal, child and adolescent health. The informing principles for the choice were relevance to the main health problems, availability of a reliable data collection system, feasibility of the collection and analysis process at the two health system levels proposed and extent to which the information provides clues for policy options. The main difficulties arise from a lack of uniform systems of classification and data collection for disabilities, as well as adequate tools for assessing quality of care and quality of life. A basic framework for analysis is suggested, including further breakdown of the indicators proposed, such as analysis by birthweight and by cause of neonatal death and by mother's education and father's employment. The information provided by the health indicators put forward needs to be evaluated within the broader scenario of the child's situation so that associated factors may be identified and clues found for intersectoral policies. Two research projects were started to evaluate the feasibility and reliability of data collection and the impact on the planning process at both the regional and local health authority levels. A European-wide initiative is proposed to tackle existing methodological problems effectively and develop a common child health indicator system.