Standard 4 for improving quality of care for children and young adolescents
The eight WHO standards for improving quality of care for children and young adolescents
On 24 April, the World Health Organization (WHO) launched standards for improving quality of care for children and young adolescents in health facilities, in Entebbe, Uganda, in a meeting organized by the Network for Improving Quality of Care for Maternal, Newborn and Child Health (Quality of Care Network) and WHO, in partnership with USAID, and hosted by the Uganda Government. Health experts from 12 countries, including all the countries in the Quality of Care Network, gathered to share how they are working to improve the quality of care for children and young adolescents, discuss how they can weave these standards in their existing national programmes, and what kind of support they will require to do so.
In 2016 alone, an estimated 6.6 million children and young adolescents died, mostly from preventable causes. Evidence from studies shows that despite progress made in increasing coverage, the gap in quality of care is contributing to complications and deaths among children,.
With these paediatric standards, WHO recognizes that children aged 0 to 15 years have specific health, physical, psychosocial, developmental and communication needs and set what is required to meet those needs. Crucially, they call for care to go beyond just treatment, and encompass the overall wellbeing of children. This will require children-centered care, and children to be involved in their care, an approach demanding changes in both the way facilities are set up, and how health workers approach children:
‘The environment needs to change so that facilities become child-friendly: children must be able to have a parent with them if they spend the night in hospital; they need several meals a day; a place to play. And health workers must involve children in their care, not bypass them and communicate only with the parents. Children have a right to know what is happening, what kind of treatment they are receiving and what the consequences are’ says Wilson Were, Medical Officer, Child Health Services, World Health Organization.
The paediatric standards call for improved provision of care, with access to evidence-based care, proper health data collection and use to improve the care of every child, and swift referrals. They also seek to improve children’s experience of care, demanding that children and their families be respected, protected and supported emotionally, and actively involved in the care they receive. And the standards require a child-and adolescent-friendly environment, such as facilities that provide a play area, enable children to study and stock child-friendly medicines and equipment.
The standards address provision of evidence-based care for the most common acute and chronic conditions that affect children and adolescent in health facilities such as pneumonia, diarrhea, fever, acute malnutrition, tuberculosis, and HIV infection. But they go beyond health conditions and look at other determinants of health, requiring that children be routinely screened for evidence of any form of maltreatment, including neglect and violence.
The paediatric standards of care are the second set in a series of standards for quality of care and compliment WHO’s standards for improving quality of maternal and newborn care in health facilities published in 2016. They are intended as a resource to empower policy-makers, health care professionals, regulators and professional bodies to work effectively towards continuous quality improvement in child and adolescent health.
- Policy brief: standards for improving quality of for children and young adolescents in health facilities
- More on quality of care: http://www.who.int/maternal_child_adolescent/topics/quality-of-care/en/
- Publications on quality of care standards: http://www.who.int/maternal_child_adolescent/documents/care-quality/en/
 Hoque DM, Rahman M, Billah SM, et al. An assessment of the quality of care for children in eighteen randomly selected district and sub-district hospitals in Bangladesh. BMC Paediatrics. 2012;12:197. doi:10.1186/1471-2431-12-197
 Lazzerini M, Shukurova V, Davletbaeva M, et al. Improving the quality of hospital care for children by supportive supervision: a cluster randomized trial, Kyrgyzstan. Bulletin of the World Health Organization. 2017;95(6):397-407. doi:10.2471/BLT.16.176982.
 Integrated management of childhood Illness. Chart booklet. Geneva: World Health Organization; 2014 (http://www.who.int/maternal_child_adolescent/documents/IMCI_chartbooklet..., accessed 11 December 2017).