Issues in Comprehensive Pediatric Nursing, 2014; 37(2): 81–86 ß Informa Healthcare USA, Inc. ISSN: 0146-0862 print / 1521-043X online DOI: 10.3109/01460862.2014.905388

EDITORIAL: ALL GOVERNMENTS SHOULD REINFORCE THEIR COMMITMENT TO GIVING ALL CHILDREN A HEALTHY START IN LIFE

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Edward Alan Glasper

INTRODUCTION

In February 2014, the English departments of Health and Education updated their policy for maximizing child health (https://www.gov.uk/ government/policies/giving-all-children-a-healthy-start-in-life).

Correspondence: Edward Alan Glasper. E-mail: [email protected]

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This example of a government’s commitment to improving the health of its children is emulated in many countries and initiatives being implemented in England will be cited here as examples. It is important to stress that all governments are keenly aware that today’s children are tomorrow’s adults and that ill health in childhood can negatively influence future adult health. In this context many western nations are seeing unprecedented levels of childhood obesity which in turn is leading to insulin dependent type 2 diabetes. The impact of national policy standards in raising awareness of the problems associated with child and young person ill health cannot be over-emphasized although translating policy objectives into attainable goals can only ever be as good as the children’s nurses who deliver them. Problems Caused by Ill Health in Childhood The origins of illness in childhood can begin before the child is actually conceived and born, and factors which influence their health prior to their birth and during their early formative years can become manifest in their later years. To illustrate this, Talayero et al. (2006) have shown that babies less than 1 year of age who are fully breast fed have a lower risk of hospital admission attributable to infections. Similarly, in a systematic review of the literature Arenz, Ru¨ckerl, Koletzko, http://www.nature. com/ijo/journal/v28/n10/abs/0802758a.html - aff3and von Kries (2004) have shown through meta-analysis that breast feeding significantly reduces the risk of obesity in childhood. Similarly those children who are reared in a safe environment and have a healthy relationship with their parents are more likely to do better as they go through life. Most governments aspire to do more to nurture their children in society and if the wealth of a nation is to be invested in the health of its children it is necessary, especially for those children who grow up in the most at-risk families, to help parents give their children the best possible care. Governments want to help children be as healthy as possible by preventing illness, and encouraging healthy behaviors from pregnancy onwards. Government Strategies to Improve Child Health Public health strategies universally emphasize the importance of giving all children a healthy start to life and seek to help families deliver optimum care to their children. This starts by enabling women to have a positive experience of maternity care and in the provision of the best possible services for women and their babies.

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Maternity Care The English strategy seeks to improve maternity care by:    

Giving women a single, named midwife who will oversee their care during pregnancy and after they have had their baby. Making sure that every woman has one-to-one midwife care during labor and birth. Giving people expecting a baby a choice about where and how they give birth. Making sure that women who have postnatal depression and women who have suffered a miscarriage, stillbirth, or the death of a baby get more support from the health service.

Helping Parents to Keep Their Children Healthy All governments aspire to improve all children’s chances in life by giving families the help they need to keep their children healthy and safe. The English Healthy Child Program (https://www.gov.uk/government/publications/healthy-child-program-pregnancy-and-the-first-5-years-of-life), which is offered to all families, aims to:      

 

Help parents develop a strong bond with children. Encourage care that keeps children healthy and safe. Protect children from serious diseases, through screening and immunization. Reduce childhood obesity by promoting healthy eating and physical activity. Encourage mothers to breast feed. Identify problems in children’s health and development (for example, learning difficulties) and safety (for example, parental neglect), so they can get help with their problems as early as possible. Make sure children are prepared for school. Identify and help children with problems that might affect their chances later in life.

In addition the English Department of Health is helping mothers and young children in low-income families stay healthy through their Healthy Start program (http://www.healthystart.nhs.uk/). This initiative gives pregnant women and mothers vouchers every week to spend on milk, fruit and vegetables, and formula milk. Furthermore they can receive free vitamins, and parents can access advice on how to encourage a healthy diet and physical activity in young children through the Start4Life program (http://www.nhs.uk/start4life/ Pages/healthy-pregnancy-baby-advice.aspx). Starting in September 2014, the English government will offer free school meals to all pupils during their first 3 years of schooling.

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Encouraging Healthy Living From an Early Age In England information pertinent to ensuring a healthy pregnancy and a healthy baby is given to parents through regular emails, text messages, and short videos via the NHS Information Service for Parents (http:// www.nhs.uk/start4life/Pages/healthy-pregnancy-baby-advice.aspx). Improving the Public Health Nursing Provision Health Visiting Service Public health nurses (health visitors in the UK) and midwives have each received specialist training which gives them enhanced skills in helping families and young children to cope with the health and social problems that can occur during early life. Each in their own way has the appropriate skills and knowledge to assess and detect potential problems that can affect a child’s health and wellbeing at differing stages of the life cycle. The English health service has given a commitment to public health nursing by expanding and strengthening the health visitor public health service. To achieve this aim the English health service has provided funding to train and educate an extra 4,200 health visitors over a 5-year period to increase the support and information available to families. Protecting Children Through Immunization Immunization is the most significant medical intervention that has been introduced in society to protect babies and children from infectious disease. Andre et al. (2007) have suggested that immunization annually prevents almost 6 million deaths worldwide and believe that a comprehensive vaccination program is at the very heart of a societies’ program of public health interventions. They also suggest that misguided safety concerns in some countries are responsible a decline in herd immunity and a fall in immunization uptake by parents in the UK which has led to the re-emergence of diseases such as pertussis and measles (Godlee et al., 2011). Supporting Mothers and Children With Mental Health Problems It is recognized as important that mothers and children with mental health problems are enabled to access support as early as possible, to

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reduce the impact of poor mental health on a child and to prevent problems extending into a child’s later years. Therefore the English Department of Health is committed to: 



Spending an additional £400 million on giving more people, including children and young people, better access to talking therapies such as cognitive behavioral therapy. Ensuring that health visitors have special training to more easily identify the signs of postnatal depression in patients and to get them the help and support they need as soon as possible.

Improving Chances for Children With Vulnerable Mothers Many governments believe that in supporting vulnerable mothers they can:  

Increase a child’s chances of developing healthily. Make it less likely that a child will experience abuse and neglect.

Consequentially the English department of Health intends to double the number of places on their Family Nurse: Partnership Program (FNP), which has three aims which are to improve (1) Pregnancy outcomes, (2) Child health and development, (3) Parents’ economic self-sufficiency.

FNP is an English voluntary, preventive program for vulnerable young first time mothers. It offers intensive and structured home visiting, delivered by specially trained nurses, from early pregnancy until age two (https://www.gov.uk/government/uploads/system/uploads/attachment_ data/file/216864/The-Family-Nurse-Partnership-Program-Informationleaflet.pdf). CONCLUSION It is clear that all government initiatives which are designed to reinforce their commitment to giving all children a healthy start in life are worthwhile goals. Tackling worldwide poverty and illness in childhood will require a global effort but children’s nurses will be pivotal in that quest. DECLARATION OF INTEREST The author declares no conflicts of interest. The author alone is responsible for the content and writing of the paper.

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REFERENCES Andre, F. E., Booy, R., Bock, H. L., Clemens, J., Datta, S. K., John, T. J., Schmitt, H. J. (2007). Vaccination greatly reduces disease, disability, death, and inequity worldwide, http://www.who.int/bulletin/volumes/86/2/07-040089/en/ Arenz, S., Ru¨ckerl, R., Koletzko, B., http://www.nature.com/ijo/journal/v28/n10/abs/ 0802758a.html - aff3 & von Kries, R. (2004). Breast-feeding and childhood obesity— a systematic review. International Journal of Obesity, 28, 1247–1256. doi: 10.1038/ sj.ijo.0802758. Published online August 17, 2004. http://www.nature.com/ijo/journal/ v28/n10/abs/0802758a.html - aff1. Godlee, F., Smith, J. & Marcovitch, H. (2011). Wakefield’s article linking MMR vaccine and autism was fraudulent. BMJ, 342. doi: http://dx.doi.org/10.1136/bmj.c7452. Talayero, J. M. P., Lizan-Garcia, M., Puime, A. O., Muncharaz, M. J. B., Soto, B. S., Sanchez-Palomares, M. S., Rivera, L. L. (2006). Full breastfeeding and hospitalization as a result of infections in the first year of life. Pediatrics, 118, e92–e99.

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Editorial: All governments should reinforce their commitment to giving all children a healthy start in life.

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