Roundtable on Child Survival:
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The Hib Initiative and PneumoADIP projects brought together leading researchers in the field of global child/neonatal health for a roundtable discussion on the leading causes of childhood mortality, the areas of the world worst affected, treatment and interventions, and evaluation of interventions.|
Effective interventions to Reduce Child Mortality and Undernutriton: the Evidence |
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While progress has been made in recent years towards UN Millennium Development Goal 4 – to reduce mortality among children under 5 by two thirds -- there remain 10.3 million child deaths each year. Primary causes of death include neonatal mortality (37%), pneumonia (19%), and diarrhea (17%). Undernutrition underlies more than half of all deaths. Effective interventions exist, including breastfeeding, insecticide treated bed nets, and vaccine, which could prevent 6 million (63%) of child deaths if they reached all mothers and children. Strengthened efforts must be made to deliver these interventions to the children who need them the most. |
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Neonatal Health: Epidemiology, Interventions, and Key Challenges |
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Neonatal deaths are the largest single cause of death among children under 5. Half of neonatal deaths occur on the first day of life, and as such, linkages with maternal, home and community care are essential. An estimated two thirds of neonatal deaths could be prevented with proven interventions at high coverage, and about one-third of neonatal deaths could be prevented through improved family and community care. Ongoing research demonstrates the promise of home and community-delivered prevention and care, as well as the impact of cord and skin cleansing. Further, the development of simpler, more accurate diagnostic and referral guidelines can improve case detection and referral. |
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The Role of Nutrition in Pneumonia Disease Burden: an Update of the Evidence on Global Burden of Disease (GBD) |
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Poor nutrition describes a range of issues including malnutrition, low birth weight, vitamin and mineral deficiencies and suboptimal breastfeeding, all of which are compounded by poverty. In turn, malnutrition greatly exacerbates illness and infection in infants and children, increasing the risk of both morbidity and mortality from disease in children who are receive poor nutrition. In the newborn, low birth weight dramatically increases risk of morbidity and mortality. However, early and exclusive breastfeeding can prevent illness and death, and the underlying malnutrition associated with it. In the attempt to attain Millennium Development Goal 4, it is important to remember the important driving forces of poverty and hunger. |
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Pneumonia: the Leading Infectious Cause of Child Mortality |
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Pneumonia is the leading cause of death from infectious disease in children under 5, in spite of the fact that it is both preventable and treatable. Two bacteria, Streptococcus pneumoniae or Haemophilus influenzae type b (Hib) cause most pneumonia deaths in children, but risk of infection and death is heavily determined by nutrition, environmental, socioeconomic and individual health factors. As such, strategies to combat pneumonia include measures to prevent infection, such as hand washing, improved nutrition, and vaccines, and steps to reduce the risk of death by assuring high quality, prompt case management and referral at all levels of the health system. The inclusion of Hib and pneumococcal vaccines in national immunization programs should be an immediate priority. |
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Approaches to Improving Child Survival and Efforts to Evaluate Them |
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While Child survival efforts had saved millions of children’s lives in the past decades, many experts had noted growing apathy and the disappearance of child survival from the international agenda. More recently, efforts have been renewed, with a focus on scaling up existing effective interventions. Now, an important challenge is how to evaluate these achievements in a way that enables scaling-up and attributes impact to the appropriate interventions. |
Jennifer Bryce |
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UNICEF and Child Survival |
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Child survival is a major priority of UNICEF, the United Nations Children’s Fund. UNICEF’s current vision includes scaling-up of integrated country-specific health packages at the community level, comprehensive evaluation, contribution to the body of child survival evidence, resource mobilization and partner leverage, and program communication and advocacy. With this framework, in addition to increases in funding and strengthened partnerships, UNICEF hopes to tackle Millennium Development Goal 4 by 2015. |
Renée Van de Weerdt |
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