Child Health Surveillance System Research Articles

Injury-related childhood mortality in migrant households in a southern city of China

BackgroundSporadic evidence from China suggests that migrant children are at higher risk of injury-related mortality than local indigenous children.MethodsChild deaths from 2004 to 2008 were provided by the Shenzhen Women...

Cesarean Delivery on Maternal Request in Southeast China

To estimate the incidence of overall cesarean delivery and cesarean delivery on maternal request in southeast China in the past decade. We used data from a population-based maternal and child health surveillance system, which covers 21 cities and counties in two provinces in southeast China. We examined the rate of cesarean delivery and cesarean delivery on maternal request in 1.1 million singleton births from 1994 to early 2006. Cesarean delivery on maternal request was defined as a prelabor cesarean delivery for a singleton gestation without contraindications for vaginal delivery at 38 weeks of gestation or later. During the 13-year study period, the percentage of women who had high school or higher education increased from 13% to 46%. The overall cesarean rate increased from 22% in 1994 to 60% in 2003 and moderated to 56% in 2006. The corresponding rates of cesarean delivery on maternal request (per 100 all deliveries) were 0.8%, 22%, and 20%, respectively. The rates varied enormously among cities and counties. In some areas, cesarean delivery on maternal request accounted for half of all cesarean births. The patterns of rate change were diverse and uneven, and the pattern of risk factors changed substantially between 1994 and 2006. Nulliparity, higher education, older maternal age, having been delivered at provincial or county hospitals, and women's occupations were previously associated with rate of cesarean delivery on maternal request. The rate of cesarean delivery on maternal request no longer varies by age, hospital level, or occupation. The rate of cesarean delivery increased dramatically in southeast China in the past decade. Cesarean delivery on maternal request was the predominant contributor to the increase. III.

The prevalence of obesity and undernutrition in Scottish children: growth monitoring within the Child Health Surveillance Programme.

To assess whether anthropometric data, routinely collected as part of the Scottish Child Health Surveillance System (CHSP-PS, pre-school children; CHSP-S, school age children) could provide a means of monitoring/surveillance for obesity and undernutrition at national and health board level. A survey of 15 health boards and both surveillance systems to identify the nature of data collected, format of data, and extent to which data were accessible (e.g., via Information and Statistics Division of the Common Services Agency). Measurements of weight and height collected as part of the CHSP-PS and CHSP-S were extracted from ISD. They were then audited and missing values or implausible values quantified, and degree of dispersion of values used as an index of quality of measurements. Health Board Child Health Surveillance Systems and Information and Statistics Division, Edinburgh. Data on height and weight are currently available for 9 health boards for pre-school children and 4 health boards for school age children. This represents coverage of around 80% of the pre-school child population. Analysis of a data extract from the 39-42 month check in 1998/99, used as an example, revealed that 8% of weight and height data were missing, and approximately 1% were implausible measures. Population and health board level estimates of prevalence of obesity and undernutrition were possible and are presented. Data on height and weight are routinely collected in school age children in all health boards, however only four health boards have growth data electronically available via the school CHSP. Growth data routinely collected as part of child health surveillance for Scotland can be used to estimate population prevalence of undernutrition and obesity. These can in turn be used to monitor trends at local and national level, to monitor achievement in relation to public health targets, identify risk factors and high risk groups, and to follow cohorts over time. We describe a system of surveillance for undernutrition and obesity and identify its strengths and weaknesses.

Health equity in transition from planned to market economy in China.

This paper examines the impact of economic transition and health sector reform on health equities in the urban and rural populations of China in the 1990s. Since 1980, China has experienced a rapid economic development and fundamental transformation of its society. Three secondary data sources were used as the basis for the analysis and discussion: mortality data from the National Death Notification System; infant mortality from the National Maternal and Child Health Surveillance System; and morbidity, health care utilization and financing data from the National Health Household Interview Surveys. The analysis revealed a very complex picture with: general mortality rates decreasing in both urban and rural populations, but the differences between urban and rural increasing; declining infant mortality rates with narrowing of the urban-rural gap; health care needs declining in both urban and rural populations, but more rapidly in the urban areas; health service payments increasing in both urban and rural areas, while, at the same time, health insurance coverage decreased. The analysis suggests that despite overall improvements in the population's health status, the economic and health system policy reforms are leading to increased inequities in health care. The lowest income quintiles in both urban and rural areas are receiving less health care compared with their needs in 1998 than in 1993, and the urban-rural divide, in particular with regard to receiving inpatient health care, is widening appreciably. The reform of the health insurance system, combined with the market setting of prices for care, have had profound implications for all population groups, in particular the lower income segments and the rural populations. During the period 1993-98 the proportion of the urban population that had to cover the increasing cost of medical care themselves doubled.

The predictive value of preschool Child Health Surveillance in the detection of mild to moderate Learning Difficulties

Objectives: The Hall report (1989, 1991) specified the early detection of mild to moderate Learning Difficulties (LD) as one aim of the Child Health Surveillance System (CHS). This study examines the efficacy of the preschool CHS in the early recognition and management of children with these disorders.Subjects: All children (n=408) with mild to moderate LD born between 01/07/83 and 30/06/84 and resident in N&W Belfast.Controls: 2750 birth records and 183 full CHR's controlled for age and area.Results: - The prevalence of mild to moderate LD in N&W Belfast was 17%. Coverage of the CHS was ranging from 90% at the 2 year examination to 98% at the 4 year examination. LD were documented in only 6% of the preschool CHR. Speech delay (OR= 3.3), poor parenting skills (OR=1.21), enuresis (OR=2.4), vision (OR=1.8) and behaviour (OR=2.8) were the only preschool indicators significantly predictive of later LD. Perinatal factors such as lower social class (OR=4.6), prematurity (OR=2.1), male sex (OR=1.6), and marital status (OR = 65) were also significant. The CHS had very poor positive predictive value (<20%) in detecting LD in the preschool period. Only half the children were referred for assessment.Conclusions: The CHS as it existed bom 1933 to 1989 in N&W Belfast was pooily sensitive to the detection of mild to moderate LD. The significance of certain risk factors such as speech delay would appear to have been missed.