Child Health and Community Health Systems

© 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.

12 children under five die every minute in the world

Since 1990, significant improvements have been made in child health. The under-five mortality rate has decreased by 49%, from 90 deaths per 1,000 live births in 1990 to 46 per 1,000 in 2013. However, improvements in child survival and health have not been equally distributed and several countries and communities continue facing unacceptably high levels of child mortality. Significant gaps remain between the richest and poorest families, both between countries and within countries. Moreover, the majority of deaths in low-income countries are still from preventable infectious diseases including pneumonia, diarrhea, and malaria. Progress is hindered in many low- and middle-income countries by weak health systems, resulting in global recognition of the importance of investing in health systems strengthening, with particular focus on strengthening the community as an integral component of the broader health system.

More information:


  Ending Preventable Child and Maternal Deaths: A Promise Renewed



Simple and cost effective interventions can save lives of children

Increasing coverage in child health interventions needs to be prioritized. An essential package for children would be comprised of interventions such as:

More information:

Essential Interventions, Commodities & Guidelines for Reproductive, Maternal, Newborn & Child Health


CCM Central

Reducing inequities and increasing coverage through a Community Health Systems Approach to Child Health


While effective and low-cost interventions to improve child health and survival are known, achieving universal coverage of such services remains a challenge. However, an equity-focused approach which prioritizes the provision of services for the most deprived communities is an effective strategy to reducing the significant disparities in coverage of child health interventions. This approach focuses on strengthening Community Health Systems to reduce inequities, both by bringing life-saving services and interventions closer to the community and by utilizing key strategies to empower communities, including community participation and organization, community-based health promotion, and increased communication.


Case Example of CHSS for Child Health: The Ethiopia Health Extension Program

UNICEF has supported the Government of Ethiopia to implement the Health Extension Programme (HEP) that employs over 34,000 Community Health Workers providing services in areas not covered by existing health facilities. With its population that is predominantly rural (84%), the HEP platform has facilitated the scale up of the integrated Community Case Management (ICCM) of diarrhea, malaria and pneumonia which now covers more than 80% of the country. The HEP is one the success factors that has helped the Government of Ethiopia to reduce its under-five mortality by two thirds between 1990 and 2015 three years ahead of the schedule.



Related Links

Accelerated Child Survival and Development (ACSD)

Integrated Management of Childhood Illnesses (IMCI)


Pneumonia - the silent killer


Global Action Plan for Pneumonia launched

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