A Focus on International Child Health and Child Well-being Supporting the Child Health Strategy through Improved Child Health Data and Intelligence ChiMat Launch - 26th February 2009 University of York

International child health: messages for the UK Measures of child health and survival dominate international comparisons: more development indicators are needed Child health services in the UK compare well to other advanced economies, however child health outcomes are mixed More (experimental) research is needed to inform on best spending The UK early years policy is well placed to meet the challenges of the financial crisis

Child health research at the OECD OECD Health Database Health at a Glance series Indicators of child health and fertility Society at a Glance series Trends in child health and risk Enhancing Child well-being across the OECD Indicators of child health and risk Review of policies and services from conception to kindergarten Public spending on family and child policies

Maternal mortality in the UK is below the OECD average Maternal mortality: Deaths per live births (2006) Data source: OECD Health Data Version: December 2008 Maternal mortality: Deaths per live births (2006) Data source: OECD Health Data Version: December 2008

Health at a Glance OECD Health ministers met for the first time in May 2004 Ensure timely and accurate health data Improving the availability and comparability of health finance data Developing indicators of quality of care Improving indicators for child health (new in 2009) Smoking and alcohol consumption at age 15 Nutrition at age 11, 13, 15 Physical activity at age 11, 13, 15 Overweight/obesity at different ages (WHO-Europe data plus national surveys)

Rate reductions in UK infant mortality are comparatively slow Infant mortality: Deaths per live births (2006) Data source: OECD Health Data Version: December 2008 Infant mortality: Deaths per live births (1980 to 2006) Data source: OECD Health Data Version: December 2008

Young people across the OECD are smoking and drinking less Children smoking least one cigarette during the past week and children reporting to have been drunk two or more times Data source:OECD calculations of Health Behaviour in School-aged Children data ( to )

The UK compares well on smoking amongst youth, but drunkenness remains too high Children smoking least one cigarette during the past week and children reporting to have been drunk two or more times Data source:OECD calculations of Health Behaviour in School-aged Children data ( to )

OECD Child well-being report Develops previous child well-being analysis (Bradshaw et al, 2007 and 2009; UNICEF IRC Report Card 7) Includes analysis of input and environment Indicators of child health outcomes are included Low birthweight Infant mortality rate / Mortality rates Immunisations Risk behaviours? Health in the context of broader well-being Wikichild Expert consultation at the OECD

Rates of low birthweight babies are increasing in the UK and elsewhere Low birthweight % of total live births (1980 to 2006) Data source: OECD Health Data Version: December 2008 Low birthweight % of total live births (2006) Data source: OECD Health Data Version: December 2008

The teenage fertility rate in the UK remains high, relative success on this front is below average Percentage change in teenage fertility rate (1997 and 2006) Data source: World Development indicators, 2008 Teenage fertility rates (2006) Data source: World Development indicators, 2008

Child well-being: Conception to kindergarten Focuses on early intervention for equity and efficiency Prenatal / birth / post natal Evidence of the variation in policies across the OECD Pre-birth child allowance Birth grants and baby packs Conditional cash transfers Immunisation bonus / Health checks Cascading services Where do social policies stop being labour market policies and start being child health or well-being policies?

Prenatal medical and social interventions Life cycle – risk profile approach Staffing / stays / health checks Maternal leave policies Nutritional programs for pregnant mothers The positive effect of maternal health booklet

Preparations for childbirth vary greatly across OECD countries Births to obstetrician ratio (around 2005) Data source: OECD Health Data Version: December 2008 * Average excludes available data for Mexico (where the births per obstetrician ratio is180). Recommended pre-natal care schedule, number of visits (most recent data) Data source: OECD Child Well-being report (forthcoming)

Birth and post natal period Birth period Variation in hospitalisation Baby friendly hospitals and breastfeeding Birth grants and baby packs Postnatal period Well-child checks Home vs. centre-based follow-up Post-natal leave Child health booklets Universality vs. cascading services

The Finnish baby pack

The average UK mother spends less than two days in hospital following birth Days in hospital following a normal hospital birth (1995, 2005) Births per paediatrician (2007) Data source: OECD Health Data Version: December 2008

Child and maternal health and the global financial crisis Policies to support income maintenance around childbirth Work tests and social insurance Pre-birth payments and parental leave / In work benefits Greater role for nutritional schemes? Children without health insurance The UK is well placed to weather some of these negative outcomes.

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