IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 9, Issue 1 Ser. X. (Jan - Feb. 2020), PP 01-08 www.iosrjournals.org DOI: 10.9790/1959-0901100108 www.iosrjournals.org 1 | Page Why Missed Attendance among Children High at Well Child Clinics in Primary Care: A Literature Review Dr. Nur Ashiqin Abd Rahman 1 , Assoc. Prof. Idayu Badilla Idris 1 , Assoc. Prof. Aniza Idris 1 1 (Community Medicine Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Malaysia) Abstract: Children are minority age group who depend on parents or guardians to access healthcare services. Failure to bring children to attend their scheduled appointment at well child clinics in primary care were also known as child neglect. Missed attendance at well child clinics in primary care among children is a chronic challenge all around the world. It has caused great loss to healthcare in terms of costs and time due to underutilization of resources. It also affects the quality of patient’s treatment and outcome due to late detection. Many studies were found investigatingfactors contributing to missed attendance among adults at primary care.However, limited studies were carried outfocusing onfactors associated with missed attendance among children at well child clinics in primary care.This literature review aims to identifyfactors associated with missed attendance among children accessing preventive services in primary care usingTheory of Planned Behavior asthe theoretical framework. Based on previous literatures, factors identified were grouped into parents/guardians’ factors, children factors and healthcare services factors. The factors identified were preventable and measures can be taken to intervene this chronic problem. Key Word: Missed attendance; Children; Well Child Clinics; Primary Care. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 21-01-2020 Date of acceptance: 12-02-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Missed attendance to clinic appointment in healthcare is a common scenario globally. Based on Oxford Dictionary, missed attendance is a term used when someone did not present at a place or event when they are supposed to. Missed attendance to primary care, also known as ‘missed appointment’ or ‘do not attend’ or ‘was not brought’, is used when children do not attend their planned appointment in primary care without giving any prior notice 1-3 . Terminology of ‘do not attend’ was commonly used for children who missed attendance to healthcare appointments instead of ‘was not brought’ which might camouflage the missed attendance issues relating to children such as child maltreatment and safeguarding 1, 4 . Missed attendance to primary care is frequently seen among children due to their dependency on their parents or guardians to bring them to attend appointments 1, 5 . Many parents/guardians may not see significance of preventive care and relate attending to primary care when their child is not feeling well 6 . Missed attendance can be divided into occasionally missed attendance and serially missed attendance. According to Williamson et al, patients who occasionally missed their attendance usually have an unavoidable crisis or an understandable situation. On the other hand, the patients who serially missed their attendance usually have house instability, social problem, mental health and financial instability 7 . All children have the right to access healthcare 1, 8 and repeated or frequent missed attendance for follow up can be viewed as possible child neglect 9 . Many published journals have explored missed attendance in primary and secondary health care setting 10 . However, limited studies were found focusing on missed attendance at primary care especially among children. In contribution to this subject matter, the objective of this literature review is to identify the factors related to miss attendance among children at well child clinics in primary care. The findings from this study can be a basis to develop new policies, strategies for interventions and strengthening of programs to uplift the child health care system. Global Scenario of Missed Attendance at Primary Care among Children Missed attendance among children to healthcare happened in all parts of the world. Missed attendance to healthcare system has caused more than $1.5 billion a year 11 . Routine follow up among healthy children is a part of preventive services for children in primary care 12 . Children who missed their routine follow up may hamper their preventive care 6 . In America, the American Academy of Paediatrics (AAP) recommended at least 13 well-care visits from birth to age 6 years old which covers everything from immunization to developmental screening and preventive care 13 . On average, 56.3% of children age 0-18 years old missed their well-care visits in a 12 months