TY - JOUR
T1 - Contextual determinants of CHILDREN'S health care and policy in Europe
AU - Zdunek, Kinga
AU - Schroder-Back, Peter
AU - Alexander, Denise
AU - Rigby, Michael
AU - Blair, Mitch
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The article is part of the work of WP1 within the project MOCHA (Models of Child Health Appraised) that is funded by the European Commission through the Horizon 2020 Framework (grant agreement number: 634201). The sole responsibility for the content of this article lies with the authors. It does not necessarily reflect the opinion of the European Union (and also not of the wider project consortium). The European Commission is not responsible for any use that may be made of the information contained therein. Additionally, MB receives funding from the National Institute for Health Research (NIHR) under the Collaborations for Leadership in Applied Health Research and Care (CLAHRC) programme for North West London. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/6/27
Y1 - 2019/6/27
N2 - BackgroundThe main objective of this study was to explore the contextual determinants of child health policies.MethodsThe Horizon 2020 Models of Child Health Appraised (MOCHA) project has one Country Agent (CA) in all 30 EU and EEA countries. A questionnaire designed by MOCHA researchers as a semi-structured survey instrument asked CAs to identify and report the predominating public and professional discussions related to child health services within the last 5years in their country and the various factors which may have influenced these. The survey was issued to CAs following validation by an independent Expert Advisory Board. The data were collected between July and December 2016.The data was qualitatively analysed using software Nvivo11 for data coding and categorization and constructing the scheme for identified processes or elements.ResultsContextual determinants of children's health care and policy were grouped into four categories. 1) Socio-cultural determinants: societal activation, awareness, communication, trust, freedom, contextual change, lifestyle, tolerance and religion, and history. 2) Structural determinants which were divided into: a) external determinants related to elements indirectly correlated with health care and b) internal determinants comprising interdependent health care and policy processes. 3) International determinants such as cross-nationality of child health policy issues. 4) The specific situational determinants: events which contributed to intensification of debates which were reflected by behavioural, procedural, institutional and global factors.ConclusionsThe influence of context across European countries, in the process of children's health policy development is clearly evident from our research. A number of key categories of determinants which influence child health policy have been identified and can be used to describe this context. Child health policy is often initiated in reaction to public discontentment. The multiple voices of society resulted, amongst others, in the introduction of new procedures, action plans and guidelines; raising levels of awareness, intensifying public scrutiny, increasing access and availability of services and provoking introduction of structural changes or withdrawing unfavourable changes.
AB - BackgroundThe main objective of this study was to explore the contextual determinants of child health policies.MethodsThe Horizon 2020 Models of Child Health Appraised (MOCHA) project has one Country Agent (CA) in all 30 EU and EEA countries. A questionnaire designed by MOCHA researchers as a semi-structured survey instrument asked CAs to identify and report the predominating public and professional discussions related to child health services within the last 5years in their country and the various factors which may have influenced these. The survey was issued to CAs following validation by an independent Expert Advisory Board. The data were collected between July and December 2016.The data was qualitatively analysed using software Nvivo11 for data coding and categorization and constructing the scheme for identified processes or elements.ResultsContextual determinants of children's health care and policy were grouped into four categories. 1) Socio-cultural determinants: societal activation, awareness, communication, trust, freedom, contextual change, lifestyle, tolerance and religion, and history. 2) Structural determinants which were divided into: a) external determinants related to elements indirectly correlated with health care and b) internal determinants comprising interdependent health care and policy processes. 3) International determinants such as cross-nationality of child health policy issues. 4) The specific situational determinants: events which contributed to intensification of debates which were reflected by behavioural, procedural, institutional and global factors.ConclusionsThe influence of context across European countries, in the process of children's health policy development is clearly evident from our research. A number of key categories of determinants which influence child health policy have been identified and can be used to describe this context. Child health policy is often initiated in reaction to public discontentment. The multiple voices of society resulted, amongst others, in the introduction of new procedures, action plans and guidelines; raising levels of awareness, intensifying public scrutiny, increasing access and availability of services and provoking introduction of structural changes or withdrawing unfavourable changes.
KW - Context
KW - Health policy
KW - Contextual determinants
KW - Policy drivers
U2 - 10.1186/s12889-019-7164-8
DO - 10.1186/s12889-019-7164-8
M3 - Article
C2 - 31248395
SN - 1471-2458
VL - 19
JO - BMC Public Health
JF - BMC Public Health
M1 - 839
ER -