WONCA's written contribution to World Health Organization's hearing on ending childhood obesity

WONCA was invited to a meeting at WHO Headquarters on October 14 for a discussion on childhood obesity. Dr Luisa Pettigrew, WONCA WHO liaison person prepared this statement which was endorsed by WONCA Executive.

The World Organization of Family Doctors (WONCA) is grateful for the opportunity to submit a written contribution to the World Health Organization's hearing with nongovernmental organizations on the Commission on Ending Childhood Obesity which will take place on 14th October 2014. WONCA hopes to be able to contribute further to future consultations and ongoing work in this area.

WONCA represents around half a million family doctors in over 130 countries and territories across the world. The mission of WONCA is to improve the quality of life of people through fostering high standards of care in family medicine/general practice.

Primary care is a key mechanism through which to achieve universal health coverage and reduce the global burden of non-communicable diseases, including childhood obesity. Primary care at its best delivers high quality, community based, comprehensive, continuous, coordinated care to people of all ages. This holistic approach to care means that primary care is ideally placed to contribute to the goal of ending childhood obesity through the ongoing care of children, from the ante-natal period through to adulthood, and importantly of their carers and of the community in which they live. Family doctors with the support of multi-disciplinary primary care teams should therefore play a fundamental role in identifying, treating and helping prevent childhood obesity globally [1-5].

While the evidence is clear that family doctors and family practice teams can play an important role in contributing towards national efforts to reduce childhood obesity, in some countries there may be country-specific and community-specific barriers to an effective response. Documented barriers can include; inadequate training (undergraduate, postgraduate and continuous professional development) with regards to the early identification of risk factors, diagnosis and interventions [2-4, 6-14]; lack of clarity and inconsistency of relevant guidelines and definitions [15, 16]; inadequate access to allied healthcare professionals in the community e.g. nutritionists, psychologists [12, 16]; limited primary care based research regarding which interventions work best in primary care to prevent and treat childhood obesity, notably from low and middle income countries [8, 16-21]; relative underfunding of primary care in order to provide sufficient resources and incentives for primary care professionals to deliver the required services [12, 16]. In addition poor integration of care between primary care, secondary care, schools and social services is likely to undermine the effectiveness of primary care based interventions.

It should also be emphasised that although primary care can play a valuable role in advising families about the risks of childhood obesity and effective ways to avoid or treat this problem, the main causes lie outside their control. Suitable actions must be taken at a public health and governmental level to reduce advertising and consumption of foods and drinks that are rich in sugar and fat, and to encourage exercise during childhood.

Success would be measured by a reduction in prevalence of childhood obesity and associated morbidity. In order to ensure accountability policymakers, funders of primary care, primary care professionals and patients should explore the role of indicators and other methods to assess and feedback on the quality of care delivered in primary care aimed at tackling childhood obesity.

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