Learning across the UK: a review of public health systems and policy approaches to early child development since political devolution.
child development
devolution
early years
policy
public health systems
systematic review
Journal
Journal of public health (Oxford, England)
ISSN: 1741-3850
Titre abrégé: J Public Health (Oxf)
Pays: England
ID NLM: 101188638
Informations de publication
Date de publication:
26 05 2020
26 05 2020
Historique:
received:
21
09
2018
revised:
20
12
2018
accepted:
22
01
2019
pubmed:
26
2
2019
medline:
2
12
2020
entrez:
26
2
2019
Statut:
ppublish
Résumé
Giving children the best start in life is critical for their future health and wellbeing. Political devolution in the UK provides a natural experiment to explore how public health systems contribute to children's early developmental outcomes across four countries. A systematic literature review and input from a stakeholder group was used to develop a public health systems framework. This framework then informed analysis of public health policy approaches to early child development. A total of 118 studies met the inclusion criteria. All national policies championed a 'prevention approach' to early child development. Political factors shaped divergence, with variation in national conceptualizations of child development ('preparing for life' versus 'preparing for school') and pre-school provision ('universal entitlement' or 'earned benefit'). Poverty and resourcing were identified as key system factors that influenced outcomes. Scotland and Wales have enacted distinctive legislation focusing on wider determinants. However, this is limited by the extent of devolved powers. The systems framework clarifies policy complexity relating to early child development. The divergence of child development policies in the four countries and, particularly, the explicit recognition in Scottish and Welsh policy of wider determinants, creates scope for this topic to be a tracer area to compare UK public health systems longer term.
Sections du résumé
BACKGROUND
Giving children the best start in life is critical for their future health and wellbeing. Political devolution in the UK provides a natural experiment to explore how public health systems contribute to children's early developmental outcomes across four countries.
METHOD
A systematic literature review and input from a stakeholder group was used to develop a public health systems framework. This framework then informed analysis of public health policy approaches to early child development.
RESULTS
A total of 118 studies met the inclusion criteria. All national policies championed a 'prevention approach' to early child development. Political factors shaped divergence, with variation in national conceptualizations of child development ('preparing for life' versus 'preparing for school') and pre-school provision ('universal entitlement' or 'earned benefit'). Poverty and resourcing were identified as key system factors that influenced outcomes. Scotland and Wales have enacted distinctive legislation focusing on wider determinants. However, this is limited by the extent of devolved powers.
CONCLUSION
The systems framework clarifies policy complexity relating to early child development. The divergence of child development policies in the four countries and, particularly, the explicit recognition in Scottish and Welsh policy of wider determinants, creates scope for this topic to be a tracer area to compare UK public health systems longer term.
Identifiants
pubmed: 30799501
pii: 5364180
doi: 10.1093/pubmed/fdz012
pmc: PMC7251421
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
224-238Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of Faculty of Public Health.
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