Luxembourg's National Health Observatory (Observatoire national de la santé - ObSanté) has announced it dedicated its first thematic annual report to child health and the response of the health system to the needs of children.
Good health during childhood is a major determinant of physical and mental development. A healthy upbringing not only impacts a child's life during their younger years; it is also the foundation of healthy living throughout their growth and development, ObSanté noted. The development of this report was guided by a validated reference framework for this type of systemic evaluation and is based on available, reliable and comparable indicators relating to the health of the child, from conception to the age of twelve. This set of indicators, based on data collected from various sources, provides a look at the past and present of children's health in Luxembourg and provides a baseline for future assessments.
Main findings relating to health status and health-related behaviours
At the age of eleven to twelve, overweight and obesity will affect one in five children in 2022, a steady increase in recent years, from 15% to 22% among boys and from 11% to 16% among girls between 2014 and 2022. Except for fruit and vegetable consumption, healthy behaviour indicators have not improved or have even deteriorated: only 57% of boys and 36% of girls report practising a sustained physical activity at least four times per week in 2022.
A significant proportion of health problems affecting children are preventable: almost one in three schoolchildren aged five to seven had untreated cavities in 2022-2023 and around one in seven children were treated for trauma in an emergency service, each year between 2013 and 2020.
Measuring health status, as experienced by children, reveals that less than half of children aged eleven to twelve believe their health is excellent in 2022, and the proportion of children who have psychosomatic complaints increased: in 2022, 43% of girls and 29% of boys experienced multiple health problems several times a week, or even daily, in the last six months. These proportions are similar to those of neighbouring countries, but in Luxembourg, the economic disparities are obvious and have widened between 2014 and 2022.
The health system’s response to the needs of children
In Luxembourg, paediatricians play a leading role in primary care for children under ten years old: in 2022, paediatricians provided 97% of consultations for children under one year old, 86% of consultations for children aged one to three years, and 63% of consultations for children aged four to nine years, while general practitioners provided 3%, 14% and 37% respectively.
More than 40% of paediatricians are over 50 years old. Nevertheless, the number of paediatricians is increasing and, with 0.19 paediatricians per 1,000 inhabitants, the density of paediatricians is higher in Luxembourg than in Belgium, France and the Netherlands and similar to that of Germany.
The participation rate in recommended health check-ups, screenings and vaccination programs is greater than 90% among children under two years old. However, these participation rates drop after the second birthday: 40% of children participate in screening for language disorders with a hearing test 30 months after birth, 21% in the two medical consultations and only 5% in the two dental visits. for preventive purposes between two and four years.
The very low levels of unmet need for medical and dental care among children in Luxembourg, however, indicate that the health system provides equitable access to these services.
Specialised hospital care for children is centralised at the Kannerklinik of the Centre Hospitalier de Luxembourg (CHL). At the national level, the density of hospital beds for paediatric care decreased between 2017 and 2021 and stands at 3.9 beds per 10,000 children in 2021.
Socioeconomic differences
The report highlights significant socioeconomic disparities in children's health behaviours and health status. Children from less well-off families adopt less healthy behaviours than children who consider themselves living in a well-off family, and their state of health is poorer. Available data suggests that this gap has widened between 2014 and 2022.
Recommendations
The report also includes several proposals aimed at improving children's health and facilitating the measurement and evaluation of the impact of the health system, programmes and actions on children's health.
The full report can be accessed at the following link: https://sante.public.lu/fr/espace-obsante/rapport-thematique-sante-enfant.html.
