Continuing the child survival revival

Abstract

There is much to celebrate in child health. Over the past 20 years, global mortality among children younger than 5 years has decreased by 41%, from 87 deaths per 1000 livebirths in 1990 to 51 in 2011. 1 UNICEFWHOWorld BankUNLevels and trends in child mortality: report 2012. United Nations Children's Fund, New York2012 Google Scholar During the same period, development assistance for maternal, newborn, and child health has increased, and has even done so through the global economic crisis. 2 The Institute for Health Metrics and EvaluationFinancing global health: the end of the golden age? Institute for Health Metrics and Evaluation, Seattle, WA2012 Google Scholar Recent international initiatives, such as Every Woman Every Child, the UN Commission on Life-Saving Commodities for Women and Children, and A Promise Renewed, have also reinvigorated the child survival agenda. But the job is far from finished. Time trends hide the real tragedy: 6·9 million children under the age of 5 years still died in 2011, largely from preventable causes. 1 UNICEFWHOWorld BankUNLevels and trends in child mortality: report 2012. United Nations Children's Fund, New York2012 Google Scholar Furthermore, the world is not on track to meet Millennium Development (MDG) Goal 4, a two-thirds reduction in child deaths between 1990 and 2015. 3 UNMillennium Development Goals. Goal 4: reduce child mortality. http://www.un.org/millenniumgoals/childhealth.shtml Google Scholar Global burden of childhood pneumonia and diarrhoeaDiarrhoea and pneumonia are the leading infectious causes of childhood morbidity and mortality. We comprehensively reviewed the epidemiology of childhood diarrhoea and pneumonia in 2010–11 to inform the planning of integrated control programmes for both illnesses. We estimated that, in 2010, there were 1·731 billion episodes of diarrhoea (36 million of which progressed to severe episodes) and 120 million episodes of pneumonia (14 million of which progressed to severe episodes) in children younger than 5 years. Full-Text PDF Interventions to address deaths from childhood pneumonia and diarrhoea equitably: what works and at what cost?Global mortality in children younger than 5 years has fallen substantially in the past two decades from more than 12 million in 1990, to 6·9 million in 2011, but progress is inconsistent between countries. Pneumonia and diarrhoea are the two leading causes of death in this age group and have overlapping risk factors. Several interventions can effectively address these problems, but are not available to those in need. We systematically reviewed evidence showing the effectiveness of various potential preventive and therapeutic interventions against childhood diarrhoea and pneumonia, and relevant delivery strategies. Full-Text PDF Bottlenecks, barriers, and solutions: results from multicountry consultations focused on reduction of childhood pneumonia and diarrhoea deathsMillions of children still die unnecessarily from pneumonia and diarrhoea, mainly in resource-poor settings. A series of collaborative consultations and workshops involving several hundred academic, public health, governmental and private sector stakeholders were convened to identify the key barriers to progress and to issue recommendations. Bottlenecks impairing access to commodities included antiquated supply management systems, insufficient funding for drugs, inadequate knowledge about interventions by clients and providers, health worker shortages, poor support for training or retention of health workers, and a failure to convert national policies into action plans. Full-Text PDF Ending of preventable deaths from pneumonia and diarrhoea: an achievable goalGlobal under-5 mortality has fallen rapidly from 12 million deaths in 1990, to 6·9 million in 2011; however, this number still falls short of the target of a two-thirds reduction or a maximum of 4 million deaths by 2015. Acceleration of reductions in deaths due to pneumonia and diarrhoea, which together account for about 2 million child deaths every year, is essential if the target is to be met. Scaling up of existing interventions against the two diseases to 80% and immunisation to 90% would eliminate more than two-thirds of deaths from these two diseases at a cost of US$6·715 billion by 2025. Full-Text PDF