Health

Accelerated child survival

© UNICEF Nepal/2008/Panday

Community health volunteer Mathura Shahi attends to mothers and their babies in a remote village in western Nepal, where some 50,000 women have been trained to provide key services and interventions for pregnant women and children.

The past 20 years have witnessed improvements in child survival worldwide, due to increased coverage of effective public health interventions and better economic and social performance. Nevertheless, about 9.7 million children die yearly. The majority of deaths in children under the age of 5 years are due to a small number of common, preventable and treatable conditions, such as pneumonia, diarrhoea, malaria, malnutrition and neonatal conditions, occurring singly or in combination.

Scaling up existing interventions is critical to accelerating progress on the health-related Millennium Development Goals for children and women, particularly in sub-Saharan Africa and South Asia, which together accounted for more than 80 per cent of all child deaths in 2006.

Priority child survival interventions
The key to making progress towards the attainment of Millennium Development Goals (MDG) 4 and 5 and elements of MDGs 1, 6, and 7 is to reach every newborn and child in every district with a limited set of priority interventions. Evidence shows that there are a number of known and affordable interventions that if implemented fully could prevent 63% of current childhood mortality.

The priority child survival interventions that need to be implemented at scale fall within the realm of:

• Newborn care, taking into consideration the life cycle approach and continuum of care; 
• Infant and young child feeding, including micronutrient supplementation and deworming;
• Provision of maternal and childhood immunization and promotion of new vaccines;
• Prevention of mother-to-child transmission (PMTCT) of HIV;
• Prevention of malaria using insecticide-treated nets (ITNs) and intermittent preventive treatment of malaria (IPT);
• Management of common childhood illnesses and severe acute malnutrition, including at community management where applicable using the Integrated Management of Childhood Illness (IMCI) strategy; 
• Management and care of HIV-exposed or infected children

At the programmatic and policy levels, it is not enough simply to expand the delivery of packages of low-cost, proven interventions: behavioral, institutional and environmental impediments that can impede access must also be addressed as part of the scaling-up process. Success requires an in-depth understanding of these obstacles, as well as of the strategies for circumventing them.

Unite for children

The overarching goal of UNICEF is to engage all relevant actors – in the community, nationally and around the world – to unite to deliver the best possible results for children. UNICEF works intensively with partners to accelerate the scaling-up of well defined, evidence-based and integrated package of low cost, high impact child survival interventions. To this end, UNICEF supports intensifying communication with families and communities for improved health and nutrition practices; strengthening the capacity of routine health services; for child heath days, integrating the delivery of immunization with other health and nutrition interventions such as vitamin A, deworming, growth monitoring, distribution of insecticides-treated bed nets and health and nutrition education.