Exploring the scope for advocacy by paediatricians

Aims-To ascertain the type and extent of problems requiring advocacy in pae diatrics. To develop an approach for analysing problems according to their root causes and the level of society at which advocacy is needed. Methods-Nine paediatricians kept detailed clinical diaries for two weeks to identify problems. Classifications were developed to categorise problems b y cause and the level of society at which they needed to be addressed. The press was surveyed for one week for childhood issues attracting media atten tion. Results-60 problems requiring advocacy were identified. Root causes include d failures within agencies, between agencies, and inadequate provision. In addition to advocacy required individually, "political" action was needed a t the community level (16 issues), city level (16 issues), and nationally ( 15 issues). 103 articles were found in the press, these did not relate clos ely to issues identified by clinicians. Conclusions-Many opportunities for advocacy arise in the course of daily wo rk. A systematic way of analysing them has been developed for use in planni ng action. To optimise the health and health care of children, there is a n eed to train and support paediatricians in advocacy work fbr local as well as national issues. Ten issues were identified that might be prioritised by paediatricians working on an agenda for action.