Child Survival addresses the major causes of under five mortality, especially diarrhea, acute respiratory infections (ARI) and malaria with an integrated set of interventions related to child health, nutrition, and water and sanitation.
Different approaches have been adopted by UNICEF within this area, given its cross-cutting nature and the specific characteristics of the areas of implementation. The two major integrated approaches currently adopted are the West-African Accelerated Child Survival and Development Program (ACSD) and the Integrated Management of Childhood Illness (IMCI). Furthermore, other more vertical interventions addressing specific diseases are also implemented at the country level, usually within the context of such integrated approaches.
Accelerated child survival and development (ACSD)
Of the nearly 11 million children who die each year, nearly two thirds die from a limited number of preventable and treatable diseases including malaria, acute respiratory infections (ARI), diarrhoea, measles, pertussis, neonatal tetanus and, increasingly, HIV/AIDS. The underlying cause of over half of these deaths is malnutrition. These conditions disproportionately affect the poorest populations world wide, particularly in sub-Saharan Africa and South Asia. Malaria accounts for about one in five of all childhood deaths in Africa. During pregnancy, it affects the health of both the infant and the mother, resulting in maternal anaemia and low birth weight, and contributes to higher infant mortality and to impaired child development. Similarly, AIDS, resulting from infection with HIV, increases susceptibility to diarrhoea, ARI, tuberculosis and other infections.
UNICEF, in collaboration with national governments, is supporting the active implementation of the Accelerated Child Survival and Development (ACSD) programme to reduce infant, under-five and maternal mortality in West and Central Africa.
The programme currently focuses on more than 16 million people in selected districts in 11 countries in West and Central Africa that have high under-five mortality rates. It has evolved into a child health strategy for the entire UNICEF West and Central Africa Region.
The ACSD programme is an integrated, results-based approach that includes the Expanded Programme on Immunization, prevention and case management of the main childhood killer diseases and antenatal care.
What makes the programme accelerated?
The ACSD programme expands coverage of proven cost-effective interventions. It focuses on women and children, integrates interventions at the facility, community and family levels, adopts a human-rights-based approach to programming, and accesses the hard-to-reach to ensure a sustainable and equitable impact. ACSD addresses two key UNICEF priorities: Early Childhood and Immunization Plus.
An integrated, results-based approach
More than 11 of the 16 million people that are covered by the ACSD strategy are in Mali, Senegal, Ghana and Benin. Of these, almost 3 million will be reached using a high-impact package of innovative and cost-effective interventions, including Immunization Plus, Integrated Management of Childhood Illness (IMCI) Plus and an antenatal Care (ANC) Plus package.
The remaining districts of the selected regions in Mali, Benin, Ghana and Senegal are implementing Immunization Plus and malaria control activities, with a view to introducing the full package in 2003. Seven other countries are implementing a limited package of interventions, namely Burkina Faso, Cameroon, Chad, Gambia, Guinea Bissau, Guinea Conakry and Niger. This limited package includes Immunization Plus and malaria control activities.