Availability and Implementation of Guidelines in European Child Primary Health Care: How Can We Improve?
Clinical guidelines are important for providing high-quality child primary health care. We aimed to assess the availability, use and achieved delivery of guidelines and the European Union (EU). We used a case study design to ascertain expert views on the guideline availability and implementation in six countries representing the EU. The experts completed an online questionnaire (response 49%) on guidelines regarding three topics that represent prevention, physical and mental health care, i.e.
... health care, i.e. vaccination, asthma care and assessment of mental health of children. All countries had guidelines available for asthma care. For vaccination and mental health assessment respondents less agreed that guidelines were available. Implementation of guidelines for vaccination was mostly as intended, but implementation of the guidelines for asthma care and mental health assessment was limited. Notable barriers were complexity of performance, lack of training of professionals or financial resources. Important facilitators for guideline implementation were the fit with routine practice, knowledge and skills of professionals and policy support. We found no clear relationship of guideline availability and implementation with the country's type of child primary health care system, though strong governance and sufficient financial resources seemed important for guideline availability.Conclusion: Availability and implementation of clinical guidelines in child primary health care vary between EU countries. Implementation conditions can be strongly improved by adequate training of professionals, stronger governance and sufficient financial resources as facilitating factors. This can yield major gains in child health across Europe.