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Reducing child mortality: can public health deliver?
Jennifer Bryce1, Shams el Arifeen, George Pariyo
1Department of Child and Adolescent Health and Development, WHO, 1211, Geneva, Switzerland. brycej@who.int <brycej@who.int>
Lancet (London, England)
|July 18, 2003
Summary
Improving child survival requires better delivery of proven interventions. Strategies must be tailored to health system development, focusing on data, monitoring, and equitable coverage to achieve global child survival goals.
Area of Science:
- Global Health
- Pediatrics
- Health Systems Research
Background:
- Child survival remains a critical global health challenge, with a significant proportion of deaths preventable.
- Coverage of essential child health interventions is insufficient in many low- and middle-income countries.
- Progress in immunisation and attended delivery coverage is stagnating or declining in some of the poorest nations.
Purpose of the Study:
- To emphasize the distinction between child health interventions and their delivery systems.
- To advocate for tailoring delivery strategies based on health system development stages.
- To review child health initiatives and discuss critical delivery system components.
Main Methods:
- Review of recent child health initiatives and delivery system strategies.
- Analysis of essential aspects of health service delivery, including data needs and monitoring.
- Discussion on achieving high and equitable intervention coverage.
Main Results:
- Effective child survival interventions are underutilized due to inadequate delivery systems.
- Data at the subnational level is crucial for effective health planning and resource allocation.
- Community-based initiatives can supplement weak health services, but national system strengthening is paramount.
Conclusions:
- Achieving the child survival millennium development goal necessitates significant improvements in intervention delivery strategies.
- Tailored delivery approaches, supported by robust data and monitoring, are essential for scaling up interventions.
- Strengthening national health systems is the long-term strategy for sustainable improvements in child survival.
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