ABSTRACT
Measles epidemics are still a public health challenge worldwide, necessitating a rapid response. The Jerusalem District Health Office applied a community-oriented intervention during the 2018-2019 epidemic (2150 notified cases). Program development targeted the socioeconomic and cultural characteristics of high-incidence Jewish ultraorthodox communities. Health care and community collaboration led to coverage rates of measles vaccination increasing from 80% to 95% within three months and a significant decline in incidence. Epidemic preparedness calls for maintaining the infrastructure of countermeasures combined with sustaining immunization coverage.
Subject(s)
Communicable Disease Control/organization & administration , Epidemics/prevention & control , Measles Vaccine/administration & dosage , Measles/epidemiology , Measles/prevention & control , Adolescent , Child , Child, Preschool , Community Participation/methods , Cultural Characteristics , Global Health , Humans , Immunization Programs/organization & administration , Infant , Measles/ethnology , Public Health , Socioeconomic Factors , Vaccination Coverage/statistics & numerical dataABSTRACT
PURPOSE: Pediatric preventive health services are delivered in many different formats throughout the world. In Israel, these services for young children are provided in designated Maternal Child Health Clinics (MCHC). The history and operation of Israel's MCHC have been described primarily in the Hebrew language medical literature with most of these reports being over a decade old. This paper provides an up to date summary of the evolution and current care in Israel's one-hundred-year old model for the provision of preschool preventive health services. As these clinics have been recognized by the World Organization as a model for emulation, it is important that such information be made available. Israel's MCHC provide universal care to infants and preschool children (0-6 years), free of charge. These community-based clinics provide developmental surveillance, growth monitoring, and routine childhood immunizations. Anticipatory guidance is offered to families on topics including nutrition, parenting and child safety. Screening is also performed for maternal postpartum depression and family violence. Care is given by public health nurses working in collaboration with physicians. The vast majority (> 96%) of the country's children receive care in this system. Immunization coverage rates through this system are in line with World Health Organization guidelines - over 95% overall average nationally. Unfortunately, the allocated funding has not increased in proportion to the population growth. There is ongoing debate on the role of the national government in health services: should it be that of a direct services provider or focus on guidance and regulation of the health system. CONCLUSION: MCHC well child care can help assure widespread provision of pediatric preventive health care. For this model to function, both its funding and content needs to be updated on an ongoing basis to reflect current preventive health care needs.
Subject(s)
Pediatrics/history , Preventive Health Services/history , Adolescent , Child , Child Welfare/history , Child Welfare/trends , Child, Preschool , Female , History, 20th Century , History, 21st Century , Humans , Infant , Infant, Newborn , Israel , Male , Pediatrics/trends , Preventive Health Services/methodsABSTRACT
Healthy lifestyle programs are essential for meeting the challenge of noncommunicable diseases. The Public Health Nurses Promoting Healthy Lifestyles (PHeeL-PHiNe) program engaged nurses from family health clinics in Jerusalem District and included physical activity, healthy nutrition, and motivational skills. Questionnaires were completed at baseline, postintervention, and at 18 months. Results showed a marked effect on health practices. The proportion of nurses consuming a balanced diet and the use of food labels significantly increased and were maintained over time. Short-term improvements in physical activity were also observed. Nurses who practiced a healthy lifestyle were significantly more likely to provide guidance and counseling to families on healthy behaviors.
Subject(s)
Health Promotion/methods , Healthy Lifestyle , Nurses, Public Health , Counseling , Diet, Healthy , Education, Nursing, Continuing , Exercise , Female , Humans , Israel , Male , Middle Aged , Motivation , Program Evaluation , Surveys and QuestionnairesABSTRACT
Mother and Child Health Clinics have provided preventive health services in Israel for nearly a century. The Public Health Nurses Promote Healthy Lifestyles Program was developed to assist families in adopting healthy behaviors. The program ran in the Jerusalem District from 2009 to 2011. After piloting, 175 public health nurses received training and interventions took place in 45 clinics serving parents of 167 213 infant and toddlers per year. When evaluation is completed, our hope is to incorporate the program into Mother and Child Health Clinic services regularly provided nationwide, thereby becoming an integral part of the initiative, Healthy Israel 2020.
