Mapping the health system response to childhood obesity in the WHO European Region. An overview and country perspectives (2019)

Childhood obesity is a major public health problem globally, which could undermine progress towards achieving the Sustainable Development Goals. Prevention is recognized as the most efficient means of curbing the epidemic; however, given the scale of the problem and the many children who need professional support due to the severity of the disease and/or obesity-related complications, health systems all over Europe must take steps to develop obesity management systems. The aim of this project was to assess the response of health care delivery systems in 19 countries in the WHO European Region to the childhood obesity epidemic. Although there is no doubt about its importance, prevention was not the focus of the work. We used mixed methods. Primary data were collected by administering a questionnaire to relevant stakeholders and experts through the WHO Childhood Obesity Surveillance Initiative network; this was complemented by a literature review and semi-structured interviews in selected countries. Overall, we found that a health system response to childhood obesity is lacking. Several shortcomings were identified in the areas of governance, integrated delivery of services, financing and education of the health workforce. The most commonly mentioned barriers were fragmentation of care (no clear pathways), a shortage of adequate personnel (e.g. childhood obesity specialists, nutritionists, psychologists), inadequate funding for childhood obesity management or health care in general, insufficient collaboration among sectors and settings and the lack of parental support and education. Nevertheless, we also report several practices and examples that may inspire other countries.