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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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Increasing the quality and coverage of youth-friendly services

Increasing the quality and coverage of youth-friendly services

WHO/Malin Bring
© Credits

Overview

Implications for action

Ministries of health should take the lead in guiding the provision of health services to adolescents, both within and outside the government. They should put in place initiatives grounded in national programmes on HIV, sexual and reproductive health or other topics, to improve the coverage and quality of health services for adolescents (especially those who are more likely to face health and social problems) in order to achieve clearly defined health outcomes. A combination of dedicated and integrated youth-friendly service-delivery models needs to be considered, depending on the health-system context, to ensure both universal coverage and targeted provision. The quality of services needs to be defined, measured, monitored and systematically improved.

WHO/Europe support

WHO/Europe supports countries in increasing the coverage and quality of youth-friendly services, through a national step-by-step process:

  • conducting a situation analysis of adolescent health or review of selected public health programmes (such as school health services);
  • developing a strategy to strengthen the health sector’s response to adolescent health, within the context of a broader multisectoral strategy;
  • developing, approving and disseminating national quality standards for health service provision to adolescents;
  • making quality assessment surveys in selected facilities to identify problems;
  • developing a quality-improvement plan, and overseeing its implementation;
  • reassessing quality, to monitor progress towards meeting standards for health service provision to adolescents; and
  • developing/adapting generic materials to promote and guide the implementation and monitoring of activities to implement and monitor the standards.

The approach has been applied in Kyrgyzstan, the Republic of Moldova, Tajikistan and Ukraine. Its implementation started in Kosovo (in accordance with Security Council Resolution 1244 (1999)) and Turkmenistan.

WHO/Europe facilitates experience sharing to accelerate efforts across the WHO European Region, by mapping youth-friendly service-delivery models and documenting good practices. WHO/Europe has made available 12 case studies from 9 countries on youth-friendly health services and policies, describing innovative and socially and culturally acceptable initiatives.

Background

A range of barriers hinders adolescents’ use of health services. Nongovernmental organizations (NGOs) in many countries take part in providing health services that are intended to respond to the needs of adolescents. These initiatives are often small in scale, limited in duration and uncertain in quality. Where governments provide youth-friendly services, much more needs to be done to make them widely accessible by young people regardless of their socioeconomic circumstances. So far, little effort has gone into enabling primary care practitioners to deliver services that are sensitive to young people’s needs, and experience is lacking in ways of reaching the adolescents most at risk. The potential of school health services, where available, to contribute effectively to health and development outcomes of school-age children is underexplored.

Key facts


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