Healthcare system for children and adolescents

• Over 8.6 million deaths occurred among children and adolescents (0-20 years) in 2019.
• A new Lancet series calls attention to the crisis in the children and adolescent sector, urging for a complete rehaul of the way things are being done now.

Children and development

• We have less than eight years to meet the UN’s Sustainable Development Goals, and many children and adolescent health targets are off track.
• A holistic approach that supports children and their families from before birth through early adulthood is urgently needed to build a foundation that will last a lifetime and improve health outcomes, economies, and society.
• Children are considered the bulwark of a nation’s future, and easing the passage for their growth and development is part of the process of not only ensuring the human rights of individuals but also guaranteeing a country’s hereafter.

The need for comprehensive care

• Paper explores the determinants and building blocks of thriving, from preconception through foetal development up to 20 years of age.
• It first considers conditions of survival, growth, disability and education, focusing on the crucial periods in the lifecycle before adulthood that forms the foundation for building human capital.
• It indicates that globally, an estimated 8.62 million deaths occurred between 28 weeks of gestation and 20 years of age in 2019.
• Another paper studies the impact of early life poverty on the growth and development of children.
• The authors use data from low and middle-income countries to substantiate the negative effects of early life poverty on the survival, nutrition and cognitive development of children and adolescents.
• However, there are huge inequities, and several children and adolescents do not thrive or survive because low-cost interventions are not deployed to their benefit.
• While calling for the scaling-up of evidence-based interventions for children under five years, the authors also highlight interventions for school-going children and the period of transition from childhood to adolescence.
• This includes recommendations to support mental health, and address unintentional injuries, non-communicable diseases, and neglected tropical diseases.
• They argue that structural reforms are more likely to improve service quality substantially and at scale than are micro-level efforts.
• Promising approaches include governing for quality (eg, leadership, expert management, and learning systems), redesigning service delivery to maximise outcomes, and empowering families to better care for children and to demand quality care from health and social systems.

Effects of the pandemic

• COVID-19 pandemic showed us the devastating effects that gaps in care and education can have on children.
• Health and social systems must be better equipped to work together to address the emerging needs of children and families as part of the effort to rebuild equitable and resilient services.
• The challenges faced in responding to the needs of children and families during the pandemic should serve as a wake-up call to the global community, underlining the urgent need to transform the child and adolescent health agenda on a global scale

Way forward

• Authors call for comprehensive care that spans nutrition, preventive health, education, economic, and community support across age groups from preconception through the age of 20.
• The close involvement of families, particularly in offering support right from the stage of pregnancy, continuing through the relevant years allowing the child to bloom, is also recommended strongly.
• It’s in the best interests of nations to take these recommendations in earnest, and ensure their future is taken care of in the present.