TY - JOUR T1 - Child health indicators: from theoretical frameworks to practical reality? JF - British Journal of General Practice JO - Br J Gen Pract SP - 608 LP - 609 DO - 10.3399/bjgp14X682585 VL - 64 IS - 629 AU - Anthony Dowell AU - Nikki Turner Y1 - 2014/12/01 UR - http://bjgp.org/content/64/629/608.abstract N2 - There are compelling reasons to focus on child health and also measure our efforts to improve child health outcomes. Childhood and particularly early childhood is a crucial period for development and wellbeing. Long-term cohort studies1 demonstrate that a healthy start to life can not only reduce later morbidity, but also produce individuals who are more able to participate in society.2,3General practice is increasingly recognised as having a direct influence on children’s health, from the provision of preventive services such as immunisation and Well Child checks, through to assessment and management of acute and chronic illness. Effective primary care also has an acknowledged role in reducing differences in child health outcomes between different groups in the population.4 Therefore the measurement of the impact of primary care on improving child health should be seen as a vital component of health services’ quality agendas worldwide.The assessment of quality is appropriately a major preoccupation of health services. From early work defining quality frameworks5 and the assessment of indicators,6 there is now research and policy in volume and variety. This activity has not been without controversy. The literature around quality outcomes frameworks, for example, includes not only extensive assessment of effectiveness but also well-considered commentary discussing unintended consequences. These include diversion of resources and loss of provider confidence in use of indicators if clinicians perceive them to be of poor quality or contain conflicting evidence.7There has been relatively little attention paid to child health quality indicators and guideline development in primary care settings.8 This lack of activity extends from initial indicator development to a dearth of critical assessment of the underlying purpose and … ER -