The International Children's Centre: an experience in teaching social pediatrics

The principal objective of preventive and social pediatrics is to seek solutions to the health problems of infants, children, and youth through programs that encompass and coordinate all aspects of child health and welfare. (The wording "preventive and social pediatrics" is unsatisfactory. It could lead to the misunderstanding that one is dealing with still another pediatric subspecialty. It is used in this article for the sake of convenience and should be understood in the sense of the preventive and social aspects of pediatrics as a whole.) Since pediatricians are increasingly involved in problems that exist prior to pregnancy and during the prenatal and birth periods (genetic counseling, monitoring of fetal growth in coordination with obstetricians) and, much later, in the physical and psychosocial problems of adolescents, the teaching range of the social aspects of pediatrics must be broadened. To be more precise, preventive pediatrics is concerned with the prevention of diseases and disabilities and with the preservation and supervision of the health of children, whereas social pediatrics deals mainly with children, both healthy and ill, in relation to their families, the community, the school, and the total environment. As far as these milieux are concerned, it is possible to identify the micromilieu: the child, dependent on the play of forces between inborn and acquired influences, in close contact with its restricted nuclear family; the mesomilieu: interrelationships between the child and the extended family, other children, crèches, preschool facilities, and schools; the macromilieu: the complex network of state and national policies, regulations, and legislation concerned with the health and development of children; the megamilieu: global problems such as poverty, overpopulation, malnutrition, pollution, violence, and wars, which primarily affect children.