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Towards a re-orientation of the Austrian ‘Parent–child preventive care programme’

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Abstract

Aim

In 1974, a preventive care programme for expectant mothers and children was introduced in Austria: the ‘mother-child-pass’. The aim of this study was to provide the Austrian Ministry of Health with a decision support for adapting the parent–child screening policy regarding contemporary medical and social health threats.

Subjects and methods

We gathered epidemiological data mainly via searching websites and reference lists by hand. In terms of ante- and postnatal screening practices, nine European experts provided information via a survey. With regard to financing, we conducted interviews with national experts and analysed policy documents.

Results

Our analysis showed a lack of epidemiological data on health threats affecting pregnant women and children from Austria. However, we identified four populations of women at risk, depending on age, socioeconomic situation, pre-existing chronic diseases or addictive disorders, and multiple pregnancies and preterm births. Unlike Austria, several European countries offer additional parent–child screenings focussing on sociomedical risk factors. Regarding financing, several publicly financed in-kind services and monetary transfers exist during pregnancy and early childhood with little coordination between them. Public expenditure is highest for hospital care and monetary benefits.

Conclusion

A parent–child preventive care programme which is primarily ‘medically oriented’ fails to identify particular populations at high risk of sociomedical health threats. Furthermore, the re-orientation of the Austrian ‘mother-child-pass’ may require the consideration of health visiting programmes to provide ‘easy-to-access’ services. From an economic perspective, the evidence suggests that a re-allocation of resources, i.e., from monetary transfers to in-kind services, is preferable.

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References

  • Amt der Steiermärkischen Landesregierung (2010) Kinder- und Jugendgesundheitsbericht 2010 für die Steiermark. Amt der Steiermärkischen Landesregierung, Graz, Austria

    Google Scholar 

  • Arbeitsgemeinschaft für Kinder- und Jugendhilfe (2010) Kinder von psychisch erkrankten und suchtkranken Eltern: Diskussionspapier der Arbeitsgemeinschaft für Kinder- und Jugendhilfe – AGJ. http://www.agj.de/pdf/5/Kinder_psychisch_kranker_Eltern%20(2).pdf. Accessed 08 Oct 2010

  • Atzpodien K, Schlaud M, Thierfelder W (2007) Allergische Erkrankungen im Kindes- und Jugendalter in Deutschland - Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS). UMID 3:12–15

    Google Scholar 

  • Barkmann C, Schulte-Markwort M (2007) Psychische Störungen im Kindes- und Jugendalter. Epidemiologie und Diagnostik. Monatsschr Kinderheilkd 155:906–914

    Article  Google Scholar 

  • Bundesministerium für Frauen und öffentlichen Dienst (2010) Frauenbericht 2010: Bericht betreffend die Situation von Frauen in Österreich im Zeitraum von 1998 bis 2008. Bundeskanzleramt Österreich, Vienna

    Google Scholar 

  • Czypionka T, Kraus M, Riedel M, Röhrling G (2011) Health workforce: Status quo und neue Berufsbilder. HSW I:1–16

  • Dekker G, Sibai B (2001) Primary, secondary, and tertiary prevention of pre-eclampsia. Lancet 357:209–215

    Article  PubMed  CAS  Google Scholar 

  • Dolk H, Loane M (2009) EUROCAT special report: the status of health in the European Union—congenital malformations. http://www.eurocat-network.eu/content/Special-Report-Con-Malfs.pdf. Accessed 10 Oct 2010

  • Duckitt K, Harrington D (2005) Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ 330:565–567

    Article  PubMed  Google Scholar 

  • European Foundation for the Care of Newborn Infants (2009) EU benchmarking report 2009/2010: too little, too late? Why Europe should do more for preterm infants. http://www.enemenemini.eu/fileadmin/Daten_eu/benchmarking_report_download.pdf. Accessed 05 Nov 2010

  • Gehrmann J, Sumargo S (2009) Kinder psychisch kranker Eltern. Monatsschr Kinderheilkd 157:383–394

    Article  Google Scholar 

  • Gesundheit Österreich GmbH (ÖBIG) im Auftrag des Bundesministeriums für Gesundheit Familie und Jugend (2007) Zahnstatus 2006. Sechsjährige Kinder mit und ohne Migrationshintergrund in Österreich. Bundesministerium für Gesundheit, Familie und Jugend, Vienna

  • Haidinger G, Waldhör T, Feenstra O, Vutuc C (2007) Zur Häufigkeit und zum Schweregrad von Asthma bronchiale, Heuschnupfen und Neurodermitis bei Schulkindern in sechs Bezirken in der Steiermark. Schlussbericht der ISAAC-Studie Steiermark 2006. Abteilung für Epidemiologie, Zentrum für Public Health, Medizinische Universität Wien; Fachabteilung 8 B - Gesundheitswesen (Sanitätsdirektion), Amt der Steiermärkischen Landesregierung, Vienna and Graz, Austria

  • Heise L, Ellsberg M, Gottmoeller M (2002) A global overview of gender-based violence. Int J Gynaecol Obstet 78:5–14

    Article  Google Scholar 

  • Henrich W, Dudenhausen JW (2008) Betreuungsbedarf für Mehrlingsschwangere. Gynakologe 41:772–780

    Article  Google Scholar 

  • Hitthaller A (2008) Richtig essen von Anfang an! Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH (AGES), Bundesministerium für Gesundheit, Familie und Jugend (BMGFJ) und Hauptverband der Sozialversicherungsträger, Vienna

  • Hölling H, Schlack R (2008) Psychosocial risk and protective factors for mental health in childhood and adolescence: results from The German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Gesundheitswesen 70:154–163

    Article  PubMed  Google Scholar 

  • Hoover KW, Tao G, Kent CK (2010) Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynecol 115:495–502

    Article  PubMed  Google Scholar 

  • Horak JF, Fazekas T, Zacharasiewicz A, Eber E, Kiss H, Lichtenschopf A, Neuberger M, Schmitzberger R, Simma B, Wilhelm-Mitteräcker A, Riedler J (2012) Das Fetale Tabaksyndrom: Ein Statement der Österreichischen Gesellschaften für Allgemein- und Familienmedizin (ÖGAM), Gynäkologie und Geburtshilfe (ÖGGG), Hygiene, Mikrobiologie und Präventivmedizin (ÖGHMP), Kinder- und Jugendheilkunde (ÖGKJ) sowie Pneumologie (ÖGP). Wien Klin Wochenschr 124:129–145

    Article  PubMed  Google Scholar 

  • Kahl H, Dortschy R, Ellsäßer G (2007) Injuries among children and adolescents (1–17 years) and implementation of safety measures: results of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 5(6):718–727

    Google Scholar 

  • Kiss H, Petricevic L, Husslein P (2004) Prospective randomised controlled trial of an infection screening programme to reduce the rate of preterm delivery. BMJ 329:371–374

    Article  PubMed  Google Scholar 

  • Larsson PG, Fåhraeus L, Carlsson B, Jakobsson T, Forsum U (2007) Predisposing factors for bacterial vaginosis, treatment efficacy and pregnancy outcome among term deliveries: results from a preterm delivery study. BMC Womens Health 7:20

    Article  PubMed  Google Scholar 

  • Laucht M, Schmidt MH (2004) Mütterliches Rauchen in der Schwangerschaft: Risikofaktor für eine ADHS des Kindes? Monatsschr Kinderheilkd 152:1286–1294

    Article  Google Scholar 

  • Ludwig Boltzmann Institut für Frauengesundheitsforschung (2005) Österreichischer Frauengesundheitsbericht 2005. Bundesministerium für Gesundheit und Frauen, Vienna

    Google Scholar 

  • Martini J, Knappe S, Beesdo-Baum K, Lieb R, Wittchen H-U (2010) Anxiety disorders before birth and self-perceived distress during pregnancy: associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Hum Dev 86:305–310

    Article  PubMed  Google Scholar 

  • Mossialos E, Merkur S, Ladurner J, Gerger M, Panea R (2009) Antenatal care in Austria and selected countries. Report for the Main Association of Austrian Social Security Institutions. Main Association of Austrian Social Security Institutions, Vienna

    Google Scholar 

  • National Institute for Health and Clinical Excellence (2008) Antenatal care: routine care for the healthy pregnant woman. http://www.nice.org.uk/cat.asp?c=89310. Accessed 03 March 2011

  • National Institute for Health and Clinical Excellence (2010) Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors. Quick reference guide. http://www.nice.org.uk/nicemedia/live/13167/50817/50817.pdf. Accessed 04 March 2011

  • Neville AJ, Calzolari E (2004) EUROCAT special report: maternal obesity and risk of congenital anomalies. http://www.eurocat-network.eu/content/Special-Report-Env-Risk-Obesity.pdf. Accessed 07 Oct 2010

  • Oberaigner W, Leitner H (2008) Geburtenregister Tirol: Bericht über die Geburtshilfe in Tirol 2007. Institut für klinische Epidemiologie der TILAK, Innsbruck, Austria

    Google Scholar 

  • Oddo S, Thiel A, Klinger D, Würzburg J, Steetskamp J, Grabmair C, Louwen F, Stirn A (2008) Postpartale Depression: Ein Interdisziplinärer Therapie- und Forschungsansatz. J Gynäkol Endokrinol 2:11–18

    Google Scholar 

  • Österreichische Gesellschaft für Prä- und Perinatale Medizin (2010a) Neues Leben - Schwangerschaft - Risikoschwangerschaft: Mehrlingsschwangerschaft. http://www.perinatal.at/sites/schwangerschaft_mehrlingsschwangerschaft.html. Accessed 29 Oct 2010

  • Österreichische Gesellschaft für Prä- und Perinatale Medizin (2010b) Neues Leben - Schwangerschaft - Risikoschwangerschaft: Rhesusunverträglichkeit. http://www.perinatal.at/sites/schwangerschaft_blutgruppenunvertraeglichkeit.html. Accessed 28 Oct 2010

  • Perttu S, Kaselitz V (2006) Gewalt an Frauen in der Schwangerschaft: Handbuch für die Geburts- und Kindermedizin. University of Helsinki, Helsinki, Finland

    Google Scholar 

  • Petermann F (2005) Zur Epidemiologie psychischer Störungen im Kindes- und Jugendalter: Eine Bestandsaufnahme. Kindh Entwickl 14:48–57

    Article  Google Scholar 

  • Reck C, Struben K, Backenstrass M, Stefenelli U, Reinig K, Fuchs T et al (2008) Prevalence, onset and comorbidity of postpartum anxiety and depressive disorders. Acta Psychiatr Scand 118:459–468

    Article  PubMed  CAS  Google Scholar 

  • Richter B, Löhle E (2001) Audiologische Diagnostik bei Kindern. Monatsschr Kinderheilkd 149:877–882

    Article  Google Scholar 

  • Roberts D, Dalziel S (2006) Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. http://www.nichd.nih.gov/research/resources/upload/cochrane_collaboration_2006.pdf. Accessed 14 Oct 2010

  • Rohrmeister K, Weninger M (2006) Neugeborene drogenabhängiger Mütter. Monatsschr Kinderheilkd 154:79–89

    Article  Google Scholar 

  • Schleicher B (2010) Gesundheitliche Versorgung gewaltbetroffener Frauen. Ein Leitfaden für Krankenhaus und medizinische Praxis. Bundesministerium für Wirtschaft, Familie und Jugend, Vienna

  • Schneider S, Maul H, Freerksen N, Potschke-Langer M (2008) Who smokes during pregnancy? An analysis of the German Perinatal Quality Survey 2005. Public Health 122:1210–1216

    Article  PubMed  CAS  Google Scholar 

  • Statistik Austria (2008) Sozio-demographische und sozio-ökonomische Determinanten von Gesundheit. Auswertungen der daten Aus der Österreichischen Gesundheitsbefragung 2006/2007. Statistik Austria, Vienna

    Google Scholar 

  • Statistik Austria (2009) Jahrbuch der Gesundheitsstatistik 2008. Statistik Austria, Vienna

    Google Scholar 

  • Statistik Austria (2010) Familien- und Haushaltsstatistik: Ergebnisse der Mikrozensus-Arbeitskräfteerhebung 2009. Statistik Austria, Vienna

    Google Scholar 

  • Statistik Austria (2011) Jahrbuch der Gesundheitsstatistik 2010. Statistik Austria, Vienna

    Google Scholar 

  • Voigt M, Briese V, Pietzner V, Kirchengast S, Schneider KTM, Straube S, Jorch G (2009) Evaluation of maternal parameters as risk factors for premature birth (individual and combined effects). Z Geburtshilfe Neonatol 213:138–146

    Article  PubMed  CAS  Google Scholar 

  • Waldhoer T, Haidinger G, Wald M, Heinzl H (2006) Non-random geographical distribution of infant mortality in Austria 1984–2002. Wien Klin Wochenschr 118:341–347

    Article  PubMed  Google Scholar 

  • Wimmer-Puchinger B, Baldaszti E (2001) Mutter-Kind-Pass-Untersuchung. Bestandsaufnahme und Entwicklung von Optimierungsansätzen hinsichtlich Inanspruchnahme und Motivation. Ludwig Boltzmann Institut für Frauengesundheitsforschung, Vienna

    Google Scholar 

  • Wollmann HA (1998) Intrauterine Wachstumsretardierung. Monatsschr Kinderheilkd 146:714–726

    Article  Google Scholar 

  • Ziegenhain U, Derksen B, Dreisörner R (2003) Frühe Elternschaft: Jugendliche Mütter und ihre Kinder. Monatsschr Kinderheilkd 151:608–612

    Article  Google Scholar 

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Acknowledgements

We presented parts of this project during poster sessions at the 4th European Public Health Conference in Copenhagen, Denmark between the 9th and 12th November 2011. We thank Claudia Wild and Philipp Mad for their assistance in drafting the manuscript, Tarquin Mittermayr for gathering the literature and Ines Schumacher for collecting the data. We are grateful to all individuals from governmental bodies and health service professionals for making the effort to provide information and data.

Funding

All authors are senior researchers at the Ludwig Boltzmann Institute for Health Technology Assessment (LBI-HTA) in Vienna, Austria. The LBI-HTA is funded by national research funds (60 %) and by partner institutions (40 %), e.g., the Austrian MoH and the Federation of Austrian Social Insurance Institutions, interested in translational research. This project was carried out as decision support for the Austrian MoH.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Ludwig Boltzmann Institute for Health Technology Assessment, Garnisongasse 7/20, 1090, Vienna, Austria

    Roman Winkler, Marisa Warmuth, Brigitte Piso & Ingrid Zechmeister-Koss

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  1. Roman Winkler
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  2. Marisa Warmuth
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  4. Ingrid Zechmeister-Koss
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Correspondence to Roman Winkler.

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Winkler, R., Warmuth, M., Piso, B. et al. Towards a re-orientation of the Austrian ‘Parent–child preventive care programme’. J Public Health 21, 583–592 (2013). https://doi.org/10.1007/s10389-013-0584-5

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  • DOI: https://doi.org/10.1007/s10389-013-0584-5

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