The coronavirus crisis has caused major queues for children's and new parents' appointments to see the school doctor and child health nurses in some municipalities, with some appointments set to be cancelled altogether.
About 900 children in the city of Jyväskylä are waiting for checkups at school physicians, while just a month ago there were 500 kids in the queue. Similarly, in Tampere, around 600 young pupils are waiting to see the school doctor.
As councils scramble to clear the backlog, some mandatory child checkups will likely be missed altogether, according to a recent survey carried out by the Institute for Health and Welfare (THL).
THL's research manager, Tuovi Hakulinen, said the long queues are due to the redeployment of health care workers during the initial wave of the coronavirus epidemic last spring, and that she is concerned about the situation.
"When checkup appointments are missed or getting help is delayed, problems, illnesses and symptoms may go undetected. [Health] clinic staff emphatically stated that we will pay the price for this for a long time to come," Hakulinen said.
As child healthcare workers were shifted to carry out tasks related to the epidemic, many scheduled checkups during the spring and early summer were cancelled outright.
"In some areas, [the number of] checkups were not reduced at all, while some services were reduced arbitrarily. There were health centres where only children under six months had access to checkups, even though services should be provided in all situations," she explained.
Delays to mandatory checkups
Child health clinics ('neuvola' in Finnish) are charged with assessing and monitoring the physical and mental well-being of pre-school age children.
They also provide vaccinations, and aim to help new mothers and fathers become better parents, but they have also been hit by delays during the pandemic.
This national service is a continuation of a range of free maternity services that expectant mothers receive during the course of a normal pregnancy, including about a dozen appointments with a nurse or doctor. Attending such appointments is a precondition for mothers to receive state maternity benefits.
In Jyväskylä, mother of three Sonja Kyrönlahti ended up waiting a long time before she could get her four-year-old daughter Esteri to be seen by a doctor. The youngster's birthday was in June but did not get an appointment for a four-year checkup until mid-September.
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"We were told that there's congestion which was partly caused by corona. We got in the queue and waited for the call. We didn't know anything else," Kyrönlahti explained, but noted that there was no urgent need for her daughter to be seen, and was not particularly concerned about the wait.
"Of course, the situation would have been completely different if we had been worried about the girl for some reason," she said.
Dealing with queues
A THL survey carried out in the spring found that health services were reduced across many municipalities, regardless of the severity of local coronavirus situations. Even though the epidemic hit the Uusimaa region hardest, general health services in other areas of the country were more significantly reduced as health workers were shifted to other responsibilities.
"Now, child health clinics are trying to meet the increased need for services, to carry out the check-ups that were left over from last spring, as well as carry out their normal workloads," Hakulinen said.
In several other municipalities the queues for school physician appointments were longer than ones for infants and small children. According to a THL survey carried out in the autumn, just under a third of school health physician respondents said at least 60 percent of childrens' health checkups were not carried out last spring. Just three percent of the respondents reported that no health check ups were cancelled due to the coronavirus situation.
Three checkups
During primary school, children are only required to undergo three medical checks -- extensive exams carried out in the first, fifth and eighth grades.
Marke Hietanen-Peltola, the chief physician of the THL's children, youth and families department, said those thorough exams were very important.
"They are able to focus holistically on the well-being of the pupil, the development of adolescence, mental health issues and internal family situations like substance abuse or domestic violence," she explained, noting that if a child's fifth-grade checkup is missed, he or she will only have the chance to see a doctor in the first and fifth grades.
In Jyväskylä, clinic and physician appointments were particularly prioritised for expecting mothers and children under the age of one, but the queued appointments were dismantled in early September, according to the city's chief of school and student health care services, Paula Käyhkö.
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She said city health centres have increased physicians' shifts and even offered appointments on a few Saturdays during the autumn.
"This will continue until the queue of 500 clients has run its course," Käyhkö said, noting that appointment queues for school health care services should be handled within six weeks.
However, as coronavirus infections increase in Central Finland more than in any other region, Käyhkö said there is a risk that queues could grow again.