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Caring for children and adolescents in hospitals

WHO advises and supports countries to ensure severely ill children and adolescents in hospital receive the care they need.

In most parts of the WHO European Region, severely ill children have good access to hospitals, with established referral systems and skilled and committed nurses and doctors. Nevertheless, in some settings children remain in hospital and away from school and their families unnecessarily and for too long; receive excessive treatment with ineffective drugs and inappropriate therapies; and get inadequate support or monitoring.

The reasons for this include:

  • a lack of evidence-based clinical guidelines;
  • links between hospitals’ reimbursement from health insurance schemes or government budgets and length of stay or number of therapies, regardless of need;
  • health regulations that do not always support a rational approach to laboratory services and testing;
  • little incentive for hospitals to comply with standards of good practice;
  • aggressive marketing from pharmaceutical companies;
  • low salaries and little information for staff; and
  • financial interests of physicians.

WHO support to countries

  • Capacity building. WHO provides training and technical support to health professionals and decision-makers to strengthen child-friendly, high-quality hospital care. This includes workshops, country missions, supportive supervision and peer learning to promote best practices in neonatal and paediatric care.
  • Evidence-based research. WHO supports countries in generating and applying evidence to improve hospital care for children. For example, in Kyrgyzstan and Tajikistan, WHO has collaborated with national authorities to strengthen health systems and improve the quality of maternal, newborn and child health services. This initiative has applied research and quality assessments to guide targeted interventions and demonstrated how data-driven approaches can lead to measurable improvements in care.
  • Tools and guidelines. WHO has developed practical tools such as the Assessment Tool for Hospital Care for Children and the Standards for Improving the Quality of Care for Children and Young Adolescents in Health Facilities. These resources help countries evaluate and improve the quality of care in line with international standards. The WHO “Pocket book of hospital care for children” provides clinical guidelines for managing common childhood illnesses in hospital settings, supporting safe and effective care. The WHO “Pocket book of primary health care for children and adolescents” offers guidance for managing child and adolescent conditions at the primary care level, helping to prevent unnecessary and avoidable hospitalizations.
  • Advocacy and partnerships. WHO works with governments, professional associations and civil society to promote child-centred high-quality hospital care. By fostering collaboration and advocating for policy change, WHO helps ensure that children’s rights and needs are prioritized in hospital settings.

News

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Publications

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Improving quality of care: strengthening primary health care by avoiding unnecessary hospitalizations in Romania: health systems evaluation report

Observations from completed WHO missions show that children and pregnant women with common conditions are often admitted to hospital when they could be...

Improving the Quality of Hospital Care: strengthening primary health care by avoiding unnecessary hospitalizations in Tajikistan: health systems evaluation report

Observations from completed WHO assessment visits in countries in the WHO European Region show that children and pregnant women with common conditions...

Hospital care for children: quality assessment and improvement tool: a systematic standard based participatory approach

This tool allows for a systematic, participatory assessment of the quality of care provided to children at hospital level, and for developing a plan of...

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Addressing child and adolescent mental health

Addressing child and adolescent mental health

WHO/Malin Bring
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Overview

WHO/Europe supports countries to improve the mental health and well-being of children, adolescents and young people.

Childhood, adolescence and young adulthood are critical stages of life for mental health and well-being, when people develop skills in self-control, social interaction and learning. Negative experiences – at home due to family conflict or at school due to bullying, for example – have a damaging effect on the development of these core cognitive and emotional skills. The socioeconomic conditions under which children grow can also have an impact on their choices and opportunities in adolescence and adulthood.

Childhood and adolescence provide a unique window of opportunity to support mental health. Mental health care and support are most effective when received early; hence intervening during this period can treat and prevent mental health difficulties.

Such early intervention is needed. Currently, suicide ranks as the fourth leading cause of death among 15–19-year-olds, and 75% of mental health conditions begin by age 24. In the WHO European Region in 2021, an estimated 1 in 5 adolescents had a mental health condition. Life satisfaction has also been declining among adolescents. However, the majority of children and adolescents in need of mental health care do not receive the necessary support.

To address these issues, WHO/Europe has prioritized the mental health and well-being of children and adolescents within the WHO European Framework for Action on Mental Health (2021–2025), and operationalized it as one of the working packages of the pan-European Mental Health Coalition. Examples of initiatives include the following.

  • The WHO Mental Health Flagship, through its pan-European Mental Health Coalition and in collaboration with the WHO Office on Quality of Care and Patient Safety in Athens, Greece, is working to improve young people’s mental health by:
    • promoting engagement of adolescents and young people in mental health service design and delivery; and
    • fostering exchange of best practices in the prevention, promotion and treatment of mental ill health.
  • With the support of the Government of Greece, WHO/Europe, through its WHO Office on Quality of Care and Patient Safety, created a programme on quality of mental health care for children and adolescents, focusing on:
    • co-developing the first WHO quality standards for child and adolescent mental health services and tools to support their implementation;
    • promoting innovation to overcome common challenges for high-quality care provision for child and adolescent mental health;
    • strengthening research and data collection for child and adolescent mental health; and
    • capacity-building for policy-makers in specific countries through the first WHO Autumn School on Quality of Child and Adolescent Mental Health Care.
  • Every 4 years, WHO/Europe conducts the Health Behaviour in School-aged Children survey, a collaborative cross-national study of the health and well-being of 11-, 13- and 15-year-olds. This survey identifies the status of and trends in health and well-being among young people, including factors affecting their mental health. 
  • WHO and the United Nations Children’s Fund (UNICEF) have partnered to strengthen mental health supports for children and adolescents, including quality of care, prevention of mental health conditions and promotion of well-being, through the Joint Programme on Mental Health and Psychosocial Well-being and Development of Children and Adolescents, and the Helping Adolescents Thrive initiative and toolkit.

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