Whether children are part of a nomadic group in Algeria or live in a Brazilian favela, reaching them is often the hardest part of a development agency’s work. A clear advantage can be seized by addressing children’s needs in multiple ways at the same time, and the approach has recently gained currency as a way to accelerate progress towards the Millennium Development Goals.

Promising strategies include community Integrated Management of Childhood Illnesses, which UNICEF supports in 82 countries, and the Accelerated Child Survival and Development programme, implemented in 11 West and Central African countries. Bundling services has become intrinsic to immunization campaigns, which often provide vitamin A, weigh children to monitor growth and distribute malaria-preventing insecticide-treated mosquito nets.

Providing several services at once can stimulate demand for health care, a critical element in reaching more people. Distribution of insecticide-treated mosquito nets via immunization or around antenatal care, for example, has been shown to stimulate demand for increased health services. Integration can also help build human resources, improve logistics and secure funding across the health sector.

Bundling services is cost-effective and efficient. For example, a 2005 article in The Lancet showed that bundled interventions to promote exclusive breastfeeding in a child’s first six months and continued breastfeeding through 11 months – important for reducing under-five mortality – would cost $414 million annually (based on universal coverage in 42 countries accounting for 90 per cent of all under-five deaths in 2000); parallel delivery of the same interventions would cost $656 million, nearly 60 per cent more.

Integration can encompass multiple fields. Maternal and child health programmes, for example, can be used as an opportunity to ensure birth registration. In Malawi, offering meals at school has proved powerful in encouraging children into the classroom while improving their nutritional status; in 2005 such programmes covered about 200,000 children and are set to reach 900,000 in 2006.

Integrated approaches are also vital for child protection. Programmes in schools to detect and report child labour is one example; training health workers to detect and manage instances of child abuse is another.

The spirit of integration is also a valuable national development strategy. Coordinating action at the national level can maximize benefits, while enhancing a country’s chances of meeting its MDG targets. One example is combating HIV/AIDS through the integrated national approach known as the ‘Three Ones’: one agreed-upon action framework, one national coordinating authority, and one country-level monitoring and evaluation system.

Reduce child mortality and improve maternal health(MDG 4, 5)

Integrated programmes transform results

Reduce child mortality and improve maternal health
(MDG 4, 5)