Are child health surveillance reviews just routine examinations of normal children?

Background. The provision and content of child health surveillance (CHS) ha s changed greatly since 1990. However, its value continues to be questioned . The introduction of the personal child health record (PCHR) has provided a new means of collecting data about CHS. Aim. To identify what problems are recorded at CHS reviews in the PCHR duri ng the first year of life, and what follow-up/referrals result directly fro m these reviews. Method. A total of 28 practices were recruited from one health authority. A ll babies born to mothers registered with study practices during one year w ere followed up. Health visitors returned copies of CHS reviews recorded in children's PCHRs. Written comments on returned reviews were analysed. Results. In all, 2308 babies were entered into the study and 2001 (87%) wer e followed up for one year. A total of 7848 (78%) CHS reviews were returned . Physical problems were recorded in 58% of children at the 10-14 day, 35% at the six to eight week, and 39% at the six to nine month review. Of physi cal problems recorded at CHS reviews, 30% required follow-up in primary car e and 7% required referral to hospital. Other problems were recorded less f requently and health promotion was recorded at only 7.5% of CHS reviews. Conclusion. Child health surveillance provides important opportunities to d iscuss problems that may cause parental concern and to identify children re quiring treatment or follow-up. The design and use of the PCHR needs to cha nge to reflect increasing emphasis on health promotion.