OBJECTIVES--To monitor the implementation of a programme of health surveillance for preschool children and measure its effect on child health. DESIGN--Regular reporting to primary care teams of their own performance, and determining the overall effect of the programme on children in the district. SETTING--All practices in Northumberland health district. SUBJECTS--All children of preschool age in Northumberland (3600 births each year). MAIN OUTCOME MEASURES--Proportion of eligible children immunised and screened for abnormalities. Age at diagnosis of congenital deafness, cerebral palsy, and special educational needs. RESULTS--Over 90% of eligible children were covered by the health surveillance scheme. Child health improved over the four years after the scheme was implemented. Uptake of immunisation against measles rose from 68% to 93% of eligible children, and the average age at which congenital deafness was diagnosed fell to 9 months. CONCLUSIONS--Maintaining the effectiveness of a surveillance programme and reporting this back to primary health care teams are processes which themselves improve health
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