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Advocating for children's health: a US and UK perspective
  1. TONY WATERSTON, Consultant Paediatrician
  1. TOM TONNIGES, Director of Community Paediatrics
  1. Community Paediatric Department
  2. Newcastle General Hospital, Westgate Road
  3. Newcastle-upon-Tyne NE4 6BE, UK
  5. American Academy of Pediatrics, USA

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In this article we describe the differing American and British approaches to child health advocacy by paediatricians and paediatric organisations. In the USA, advocacy has a long history and is well established as an important function of the American Academy of Pediatrics (AAP), but the USA still has to achieve universal health care coverage for children. In contrast, the UK has had universal health care for children for more than 50 years and individual paediatricians have spoken out for children. However the Royal College of Paediatrics and Child Health (RCPCH) adopted advocacy as a goal only in 1997. In our article we pose the following questions:

  • What is advocacy and why is it a task for paediatricians?

  • In what ways can paediatricians act as advocates for their patients?

  • How do advocacy activities by paediatric organisations benefit child health?

  • What should be the focus of collaborative advocacy between US and British paediatricians?

What is advocacy?

The Oxford Dictionary defines the verb advocate as “plead or raise one's voice in favour of; to defend or recommend publicly”: in other words to stand beside, not to do for. Promoting action to effect change for children is a key component of advocacy. Generally child health advocacy efforts begin with an individual patient and may extend into local, regional, or national work in a public health capacity. Advocacy means making a commitment to support the child and family beyond the issues related to the treatment of their individual medical condition. Furthermore, the basis for advocacy is our wish to meet all of a child's health related needs within the context of family and community.1 We recognise that factors outside the realm of direct health care provision often inhibit children's ability to achieve their full potential—particularly among children from disadvantaged families. Examples of such opportunities for advocacy include …

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