1. Callister, Lynn Clark PhD, RN, FAAN

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Forty distinguished global health professionals authored a report on the work of the World Health Organization (WHO), the United Nations Children's Fund, and the Lancet Commission on child and adolescent health, suggesting that the health and future of children and adolescents should be the central focus of the Sustainable Development Goals. Comprehensive findings of the report are summarized by Clark et al. (2020) and are closely tied to the Survive-Thrive-Transform Framework of the Global Strategy for Women's, Children's and Adolescents' Health (United Nations, 2015). Key messages are invaluable to nurses caring for women, children, and adolescents.


In our clinical practice and the communities and the countries in which we live, we see evidence of food insecurity and those living in poverty even in wealthy nations, those with developmental disabilities not receiving adequate care, iniquities between diverse social and ethnic groups, those struggling with the trauma of war and violence in their lives, those who lack basic health care including mental health services, those who are deprived of education, and those who are marginalized and do not have opportunities to ensure they will reach their full potential in life. How can we ensure these issues are addressed and changes are made? How do we as maternal-child nurses find ways to make a difference in the lives of the disadvantaged? How do we more effectively foster making positive change? Nurses are integral to health promotion of children and families in the United States and globally. For example, as nurses we provide direct care in the outpatient setting and the hospital, and are an important part of the public health and public school systems. Comprehensive clinical care, education, counseling, and support for children and families by pediatric nurses contribute to numerous health outcomes.


Protective strategies begin during pregnancy, with those 9 months in utero viewed as essential to the lifelong trajectory of health and wellbeing in children. Social and environmental determinants of health determine development of children and adolescents through the course of their lives. Children should be entitled to be protected, be educated, be healthy, to be treated fairly, and be heard (Clark et al., 2020). Roles of the family, community, and government are highlighted in the work to ensure the future of children across the world.


Concerns are expressed about the challenges of commercial marketing promoting breastfeeding substitutes, addictive substances, unhealthy food contributing to childhood obesity, and poor dental health. Unregulated and inappropriate social media via the internet is of serious concern as children and adolescents are exposed to inappropriate images and gambling products which are exploitative of those who are vulnerable. The global index of 180 countries concludes children in Norway, the Republic of Korea, and the Netherlands have the postulated most positive health and wellbeing outcomes, with children in the Central African Republic, Chad, Somalia, Niger, and Mali at risk to suffer the worst outcomes globally. Children and adolescents across the globe deserve more to ensure a positive future.


It is essential we understand that children are vulnerable, and often have "little voice in the shape of their future" (Clark et al., 2020, p. 607). Meta-analyses support the positive association of childhood markers including prenatal health, birthweight, growth during the first year of life, and "peak physical and cognitive capacities" in childhood, and positive adult capacity including life expectancy (Clark et al., p. 607). Children and adolescents should be the primary focus of Sustainable Development Goal policies and suggested initiatives. In a February 19, 2020 news release from WHO (p. 1), WHO Director Ghebreyesus said this report "must be a wakeup call for countries to invest in child health and development, ensure their voices are heard, protect their rights, and build a future that is fit for children."




Clark H., Coll-Seck A. M., Banerjee A., Peterson S., Dalglish S. L., Ameratunga S., Balabanova D., Bhan M. K., Bhutta Z. A., Borrazzo J., Claeson M., Doherty T., El-Jardali F., George A. S., Gichaga A., Gram L., Hipgrave D. B., Kwamie A., Meng Q., ..., Costello A. (2020). A future for the world's children? A WHO-UNICEF-Lancet Commission. Lancet, 395(10224). 605-658.[Context Link]


United Nations. (2015). The global strategy for women's, children's, and adolescents' health. [Context Link]


World Health Organization. (2020). World failing to provide children with a healthy life and a climate fit for their future: WHO-UNICEF-Lancet.