Epidemiology and global policy in child health

Abstract

Global interest in child health has waxed and waned over the last 30 years. In the 1980s, the United Nations Children's Fund led the child survival revolution, focusing on growth monitoring, oral rehydration, breastfeeding promotion and immunizations. By the 1990s, however, global interest in the health of mothers and children had waned. Key indicators such as immunization rates, which had increased sharply in the 1980s, either stagnated or declined in the 1990s. Attempting to reverse this situation, concerned scientists and policy makers joined forces, building upon the Millennium Development Goals which included a specific target of a reduction in under-five mortality by two-thirds by 2015. Sound epidemiological research laid the foundation for selecting a handful of cost-effective interventions and advocating for their incorporation into national and international policies. Epidemiology then contributed to measuring coverage with these interventions, assessing which population groups are lagging behind, feeding this information back to policy makers on a continuous basis, and evaluating the impact of large-scale programmes. Focusing on childhood pneumonia, this paper shows how child health has improved considerably as a result of this renewed vigor and international collaboration.