The content of the new children's health certificate form No. 27-1/a was discussed with personal health care specialists

On 10 October 2014, the content of the new children's health certificate form 27-1/a was discussed with the personal health care specialists in the Institute of Hygiene. This form was discussed with public health specialists in the previous discussions. The discussion was held with the implementation of the project “Children's health monitoring information systems for the systematic monitoring of the health of children and purposeful health policy development and implementation” (NOR – LT 11 –SAM – 01 -01-TF-001) funded by the Norwegian Financial Mechanisms 2009-2014 Programme No.LT11 "Public health initiatives". 
 
22 specialists took part in the discussion – family doctors, paediatricians and representatives of the Ministry of Health. There were discussions not only about the content of the children's health certificate, but also which data is necessary to organize children's health monitoring and implement preventive measures.
 
Practitioners pointed out that some children and especially teenagers avoid being weighed due to being overweight or don't wear glasses and parents often apply for a child's health certificate during the last week of August when doctors no longer have enough time to check the child's health and qualitatively fill in the certificate form. Thus, according to expert opinions, this document should only include the child's health data that is important for educational activities, children's monitoring and preventive measures of diseases.
 
It was noted that, so far, there are no objective and reliable children's health indicators that are routinely collected annually, there is a concept of negative health when we determine the health of a certain group of people by assessing the morbidity indicators. High morbidity in children indicates poor health and preventative measures are planned accordingly in educational institutions and municipalities. It is proposed that the health certificate form should only include chronic diseases and disorders that, in the opinion of a doctor, could have an impact on the educational activities and provide recommendations according to the degree of the child's health problem.
 
Doctors expressed their concern that there are no solid methodical instructions on how to write recommendations. Odontologists do not always provide detailed information about the condition of the child's teeth and jaws. Moreover, such data is not the object of public health monitoring, thus it is considered to be surplus and under-utilized when monitoring the health of children and in preventive activities. Upon the proposal of the Ministry of Health, the said certificate form shall include information about vaccinations. The child's health certificate enables primary health care and public health care specialists working in educational institutions to share the data on children's health.
 
The child's health certificate ensures data exchange between primary health care specialists and public health care specialists working in educational institutions. Cooperation between personal health care specialists and public health care specialist is very important in order to achieve a healthier society. However, significant systemic (de jure public health separated from medicine) and resulting organizational barriers are impeding cooperation. There are existing stereotypes that public health specialists are seen as institutional inspectors with less prestigious and less significant activities, and this obstructs the cooperation on an interpersonal level. Sometimes it is hard to understand that public health specialists are also working for the benefit of the health of children but on a population-based level instead of an individual one.
 
For more information, please contact project manager Šarūnas Alasauskas by phone (8 5) 261 2084 or e-mail sarunas.alasauskas@hi.lt.