From theory to action: Implementing the WSSD Global Initiative on children's environmental health indicators
Introduction
Children’s ability to develop and become productive adults is largely determined by their earliest experiences in their families and communities. Children may be exposed to environmental threats that seriously affect their health: over 40% of the global burden of disease attributed to environmental risk factors falls on children under five years of age, who account for only about 10% of the world’s population1. Ultimately, creating healthier environments will have a demonstrable impact on children’s health and well-being. Therefore, improving children's environmental health presents an essential contribution towards the achievement of the Millennium Development Goals.
Protecting children from exposure to environmental hazards requires that we better understand the relationship between environmental conditions and health outcomes. Several recent international agreements, in particular the Plan of Implementation of the World Summit on Sustainable Development (WSSD) and the G8 Ministerial Statement on the WSSD, have specifically highlighted the need for assessing the state of children’s environmental health and monitoring progress, and have called for action to develop children’s environmental health indicators. At the regional level, the North American Commission for Environmental Cooperation, in its Cooperative Agenda for Children’s Health and the Environment (2002), calls for a set of children’s environmental health indicators to be selected and published. The Healthy Environments for Children Alliance (HECA), launched at the WSSD by the World Health Organization, also emphasizes the need to monitor the status of children’s environmental health, and to develop and report indicators.
Responding to these calls for action, a Global Initiative on Children’s Environmental Health Indicators (CEHI) was launched at the WSSD in September 20022. CEHI partners are outlined in the foreword, and the global response to the launch demonstrates that many countries are supportive of this effort. CEHI contributes to achieving HECA’s objectives, in particular to inform and influence policy-makers and to judge the effectiveness of programmes to improve children’s environmental health. CEHI will proceed as an independent effort but will be closely coordinated with HECA, as well as other WHO activities on children's environmental health, such as the preparation of national children's environmental health profiles. The objectives of CEHI and the Health and Environment Linkages Initiative (HELI)3, also launched at the WSSD, are seen as complementary and mutually reinforcing: The activities under HELI will help inform CEHI about the needs of decision-makers and about the types of information that will trigger them to decide on appropriate interventions or policies; the work of CEHI, on the other hand, will help provide the data and indicators that decision-makers need.
The need for children’s environmental health indicators was most recently emphasized during the 56th World Health Assembly in May 2003, where several countries called upon WHO to support the reporting of indicators for children’s environmental health. This further confirms the value of the Partnership launched in Johannesburg, and shows growing support for its objectives as more and more world leaders take note of children’s environmental health issues and request assistance in making the right policy decisions.
Building on its experience with respect to children's health and environmental health indicators, WHO will provide leadership on the implementation of CEHI. WHO will convene and co-ordinate the work with partners, facilitate information exchange, and provide technical support and capacity-building where necessary.
CEHI will build on existing international, regional and national work on child health and environmental indicators by initiating a series of regional pilots to develop, collect and report children’s environmental health indicators. The initiative aims to ensure equal relevance of the indicators for the health and environment sectors so that both can monitor their efforts towards realizing healthy environments for healthy children.
We encourage a “flexible approach”: Flexible with respect to regional pilots choosing for themselves which approach they would like to follow in collecting and reporting indicators. And flexible by starting off with a feasible, low-cost approach that maximizes the use of existing data and indicators and works towards a more harmonized and complete assessment of the state of children’s environmental health in the longer term (see Box 1).
Aims of CEHI
- Increase collaboration among governments, non-governmental organizations, United Nations agencies and other inter-governmental organizations, the private sector, and communities to report on the state of children’s environmental health.
- Improve assessment of children’s environmental health and monitor the success or failure of interventions to address specific children’s environmental health problems at the local, national and international level.
- Improve the quality of information available to policy-makers that will allow them to make better decisions to improve environmental conditions and child health outcomes.
- Under the UN system and with collaboration of governments, NGOs, and other interested parties, develop and promote use of children’s environmental health indicators, and, where possible, integrate children’s environmental health indicators into existing child health reporting systems as well as environmental indicator reporting systems.
- Propose modifications to existing international environment and health surveys, as well as to appropriate national and local systems, to incorporate data needs for core children’s environmental health indicators.
- Provide a global clearing house for children’s environmental health indicators that constitutes a central forum as well as resource for all relevant initiatives.