Abstract
Abstract The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.
Highlights
The primary care values to achieve health, for all require health systems that ‘Put people at the centre of health care’. (World Health Organization, 2008a)Thirty years after the Alma Ata Declaration (World Health Organization, 1978), the World Health Organization Report: Primary Care More than Ever (2008) highlights the increasing emphasis on person-centred care, as health systems adapt to rapidly changing social circumstances and increasing public expectations
The Models of Child Health Appraised (MOCHA) project set out to identify which models of primary care exist for children, whether there are particular attributes which might be different from those directed at adults and how might these models be appraised
While this work did not consider the specific needs of children, we have included this in our table of components as a variable that may be used to analyse the primary care systems for children
Summary
The primary care values to achieve health, for all require health systems that ‘Put people at the centre of health care’. (World Health Organization, 2008a)Thirty years after the Alma Ata Declaration (World Health Organization, 1978), the World Health Organization Report: Primary Care More than Ever (2008) highlights the increasing emphasis on person-centred care, as health systems adapt to rapidly changing social circumstances and increasing public expectations. As there are many private health services for adults and children where anybody has access if they pay, we can call it open access; the primary health care
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