The Italian Surveillance System for Children aged 0-2 years: a population-based approach

Abstract Issue The first 1,000 days of life are a crucial window for child development; promoting health during this phase supports lifelong wellbeing. Monitoring key health determinants during this period is essential to design effective and equitable preventive strategies. Problem description In 2014, Italy launched a national population-based surveillance system targeting children aged 0-2 years. Coordinated by the National Institute of Health and promoted by the Ministry of Health in collaboration with regional authorities, the system collects data on health indicators aligned with WHO recommendations and national/regional prevention plans. After a pilot phase in 2014, conducted in 13 local health districts across 6 regions, two full rounds were conducted in 2018 and 2022, involving 11 and 21 regions/autonomous provinces, respectively. Since 2017, the surveillance has been officially recognized as nationally relevant by the Prime Minister's Decree. Results In Italy, a national Surveillance System monitoring the first 1,000 days of life is currently realized. The Surveillance is structured as a sample survey repeated every three years, providing regionally and locally representative estimates. Data are collected through a self-administered, multilingual questionnaire distributed at vaccination appointments (first three hexavalent doses and first MMRV). Topics include folic acid intake, alcohol and tobacco exposure during pregnancy/lactation, breastfeeding, infant sleep position, family reading, screen time exposure, home and transport safety, and vaccination intentions. Maternal and family socio-demographic characteristics are also collected. In 2022, 35,550 questionnaires were collected, with a participation rate of 95%. The next round is planned for 2025. Lessons The Surveillance provides essential data for tailoring maternal and child interventions at national and regional levels. Key messages • Effective interventions in the first 1,000 days require timely, representative and updated data. • Surveillance System for Children aged 0-2 years is a key tool for evidence-based policy and planning.