PUBLIC-HEALTH SURVEILLANCE IN CHILD-CARE SETTINGS

To investigate the potential contribution of public health surveillanc e systems to the health of children and workers in out-of-home child-c are settings, we review existing public health surveillance practice i n the United States. We identify issues that are of particular concern for surveillance in child-care settings. We propose a framework for d eveloping public health surveillance systems that uses sentinel child- care sites, notifiable disease surveillance, modification of existing surveillance systems, and population surveys. Successful surveillance in these settings depends on the active participation of child-care pr oviders, public health practitioners, and clinicians in (a) the select ion of high priority diseases and injuries for surveillance; (b) the d evelopment of practical case definitions; (c) the augmentation of curr ent surveillance systems to include disease and injury related to chil d care; and (d) the implementation, assessment, dissemination, and eva luation of new approaches for surveillance in child-care settings.