中国及美国儿童保健有关规范指南比较分析

目的 介绍美国儿科学会推荐的“光明未来:婴儿、儿童及青少年健康管理指南”,并与中国现行的“全国儿童保健工作规范(试行)”(简称规范)对比,借鉴其可取之处,以进一步完善我国儿童保健规范.方法 使用多阶段方法,包括文献研究、人物访谈、中国和美国实地考察及经验总结,分析比较两国儿童保健有关规范指南在涵盖人群、内容等方面的异同.结果 美国儿童保健指南与中国规范的相似之处是都强调儿童保健工作的重要性;0～6岁儿童保健基本内容基本相似,都包括了预防免疫、生长发育监测、实验室筛查、健康教育指导等.不同之处在于我国规范仅提出笼统的原则,缺少不同年龄段的儿童保健实施的具体操作指南,儿童保健服务内容比较单一.另外,我国目前的儿童保健重点对象仅是0～6岁的儿童,对6岁以上的儿童尚没有具体的保健指南.结论 我国需要制定更为详尽的、具有指导性和可操作性的、包含所有年龄段的儿童保健指南.

A comparison of well-child care guidelines in China and the United States

Objective To describe well-child care guidelines in the United States and compare it to China＇s guidelines so as to inform child health policymakers and providers in developing improvements for China well-child care practices. Methods We used a muhistage approach to identify features of well-child care guidelines. The following methods are used： literature review, key informant interviews, site visits to both China and the United States and summarization of experiences. The differences and similarities of the contents were compared. Results Both China and the United States emphasize the importance of well-child care and the basic contents such as immunization, growth monitoring, lab screening and health education are similar for well-child care from 0 to 6 years old. Differences exist in that China＇s well-child guidelines are a set of general principles, without specific instructions, and only cover children from 0 to 6 years old. There are no guidelines in China for children older than 6 years old. Conclusions China needs a more detailed well-child care guidelines with specific instructions for all-aged children ; despite some similarities, there are applicable learnings from that of the United States＇ for improvement in China＇s.