# Framework for systems of pediatric well-care visits: a scoping review

## TL;DR

This review maps global systems for pediatric well-care visits, highlighting differences in implementation and potential benefits for child health.

## Contribution

The paper introduces a new conceptual framework for integrated well-care visit systems based on a global scoping review.

## Key findings

- 322 articles were identified, with most focusing on high-income countries.
- Systems vary by region, including health days, home visits, and clinics.
- Key components include interventions, workforce, and governance, with strategies for scaling up services.

## Abstract

Despite decades of global efforts to reduce under five mortality, 5 million children die before their fifth birthday. Numerous landmark reports have called for integrated approaches to further accelerate reductions, yet interventions are often delivered in silos and, to our knowledge, no global synthesis of the evidence for integrated preventive systems exists. We conducted a scoping review to map the existing literature on systems of well-care visits for children under five years from 2000 to 2023 globally.

A systematic search of relevant databases (MEDLINE, the Cochrane Library, Web of Science, and OVID Global Health) was conducted. In total, 8,945 unique documents were identified and after screening titles and abstracts, a total of 1587 articles were assessed for eligibility through full-text review. The information was extracted based on the WHO’s established health system framework, and from these pillars, a conceptual framework was derived on the components and the potential impact on child health care.

We found 322 eligible articles (217 primary articles, 105 reviews). Among the primary articles, close to 50% focused on high-income countries, while less than a fifth focused on low-income countries. Across regions, systems of preventive well-care visits are organized differently; from health days to home-visits, programs, and clinics. Depending on the context, the content differs (e.g., vaccinations, screenings, parent education) and the contextual challenges and solutions for implementation (e.g., mHealth, scale up existing structures).

This review identifies core components of well-care visit systems, including interventions, workforce composition, and governance structures, alongside key implementation strategies such as the scaling up of existing service delivery models. We introduce a framework for systems of well-care visits. These systems may offer child health care improvements, including enhanced attendance rates, increased service utilization, and decreased health care expenditure, thereby contributing to improved child health care for all.

The online version contains supplementary material available at 10.1186/s44263-025-00211-4.