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MOCHA Report Summary

Project ID: 634201
Funded under: H2020-EU.3.1.

Periodic Reporting for period 1 - MOCHA (Models of Child Health Appraised)

Reporting period: 2015-06-01 to 2016-11-30

Summary of the context and overall objectives of the project

Children’s health affects the future of Europe – children are citizens, future workers, parents and carers. The UN Convention on the Rights of the Child gives all children a right to optimum health and effective health services. Models of child primary health care, including school health and adolescent direct access services, vary widely across Europe but there is little research to show which are most effective. MOCHA aims to use local agents, professional networks, and earlier child health projects to model and evaluate this in all 30 EU/EEA countries. Twenty scientific partners, encompassing disciplines such as medicine, nursing, economics, informatics, sociology and policy management will identify and assess the many facets of primary care for children, also taking into account cultural, sociological and political factors. MOCHA is supported by an External Advisory Board, made up of experts from health services research, medicine, nursing, health care management, advocacy for children, the European Patients’ Forum’s youth patients’ forum and academia. In addition, partners from Australia and the USA provide important external and global context. The results will demonstrate the optimal model(s) or crucial elements of a composite model of children’s primary care with a prevention and wellness focus. The project has a strong outreach and dissemination programme to ensure dialogue with public, professionals, policy makers and politicians, and to deliver awareness and potential benefit for European children’s health and a healthy European society.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

Thus far, the MOCHA Project has run to plan and in accord with the Description of Activities, concentrating so far on identifying systems, activities and issues across the wide remit of children’s primary care as the basis to assess and appraise current provision and then to synthesise optimal model components.

Main results achieved to date are: recognition of criteria and schemas for assessing primary care systems and tracer conditions to use in this measurement; understanding of policy governance and local policy making processes; review of public concerns which influence policy-making; and consideration of the use and effects of incentives to influence service delivery and uptake. Studies have been initiated on the interface between primary and secondary care, and into the delivery of complex care for long-term conditions with concurrent preventive health. Adolescent health, and school health services, have a specific focus.

Equity of provision and delivery is under study from several dimensions including migrant children, while in five countries the views of children themselves are being sought. Studies of economic and financial analysis are in hand, as well as study of the workforce, and of the children’s care aspects of professional education curricula. The different approaches to electronic record keeping, and the availability of registers and of large searchable databases, are covered in this period.

A process of research survey design, External Advisory Board scrutiny and country agent (CA) supply of answers has been well established. We have actively sought formative feedback from professional and NGO stakeholder bodies and have established a working collaboration with WHO on School Health.

The project has established good working communication through the Annual General Assembly and 6 monthly EAB / Work Package Leads’ meetings, and monthly Work Package Leaders teleconferences.

Deliverables and Milestones

MOCHA has produced 22 deliverables to date, five of which are formal deliverables to the European Commission, all publicly available on the MOCHA website. These five are:
• Project website ( facilitating internal and external communication
• Systematic review and meta-analysis of the literature focused on timeliness of diagnosis and preventive care using tracer conditions
• Report on national policies for primary care of migrant children which indicated the failure of many Europe countries to adopt policies which meet treaty and rights obligations
• Analysis of current child health electronic record keeping showing gaps in good practice, and that the majority of countries do not mention children in their e-health policy documents
• Semantic models of key clinical conditions and outcome measures.
The remaining 17 reports are important steps towards knowledge and appraisal of the models of child health. All are posted on the private area of the website enabling all project members to draw on them; it is planned to use several as the basis for scientific publications.

The project has achieved on time five milestones: the Initial annual meeting; an operational website; development of country agent procedures and protocols; a first draft of current models of children’s primary health care; and a catalogue of child health databases in Europe.


This is an important to the project, with successful submissions to external conferences, and invitations to stakeholder events. MOCHA has presented 16 papers or workshops including at the European Forum on the Rights of the Child, WHO, European Association for Children in Hospitals, EUPHA, European Patients' Forum youth meeting, Assembly of European Regions and the European Health Management Association.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

The MOCHA project has already identified gaps in knowledge, including lack of data on surveillance of children’s primary care and children’s specific needs in primary care; lack of coordination of care; models of care that are not based on current child health epidemiology; and low prioritisation of children’s needs in e-health strategies. There is a need for focus on preventive care and on fostering good health in a population that is largely well, and can develop good habits that can lead to a healthy adulthood and old age, particularly at a time when several new Member States are reviewing and developing their health systems.

MOCHA is addressing these gaps by innovative methods. For example the MOCHA International Research Opportunity Instrument (MIROI) is increasing access to existing data sources of children’s health and outcomes of health in Europe; collaboration with WHO Geneva on School Health policy and the specific needs of children and adolescents; a review of national e-health policies held by WHO and their treatment of children’s needs; and commitment to devise and populate a matrix for assessing the strengths of primary care models and systems specifically for children.

MOCHA has held a number of invitational special focus workshops to analyse key issues in depth, largely over and above the DoA plans. The project is going beyond normal health policy research by seeking the views of young people and their parents on patterns of health service provision, facilitated by the DIPEx International organisation.

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