Accelerating progress in achieving the millennium development goal for children through community-based approaches.

Area of Science:

• Global Health
• Public Health
• Pediatrics

Background:

• Millennium Development Goal 4 (MDG4) aimed to reduce under-five mortality by two-thirds by 2015.
• Progress towards MDG4 has been insufficient, with only 16 countries on track to achieve the target.
• High-child mortality rates persist in resource-poor settings, necessitating effective interventions.

Purpose of the Study:

• To review evidence on proven interventions for reducing child mortality in high-mortality, resource-poor settings.
• To emphasize the critical role of community participation and community-based approaches in improving child health outcomes.
• To identify common community-based strategies that have demonstrated success in reducing child mortality.

Main Methods:

• Systematic review of existing evidence on child mortality interventions.
• Analysis of studies focusing on community-based primary health care (CBPHC) effectiveness.
• Synthesis of data on interventions requiring strong community participation.

Main Results:

• Interventions are most effective when implemented within communities, requiring strong community participation.
• Facility-based interventions show improved child mortality impact when integrated with community-based components.
• Specific community-based approaches have documented success in improving child survival.

Conclusions:

• Accelerating progress towards global child mortality reduction goals requires a stronger emphasis on community-based approaches.
• Effective child mortality reduction strategies must integrate facility-based and community-based interventions.
• Community-based primary health care is essential for improving child health in resource-limited environments.