There has been a substantial decline in child mortality, yet preventable causes are still taking the lives of millions of children every year. In Africa and Asia, diarrhea, pneumonia and malaria are responsible for nearly half of all deaths in children under five years of age. Despite significant progress -- including a 37 percent decline in child mortality in the past 20 years -- UNICEF estimates that nearly 21,000 children still die needlessly every day. But there is hope: almost two-thirds of child deaths can be prevented through the provision of simple, inexpensive interventions.
Here at MCHIP -- USAID's flagship Maternal and Child Health Integrated Program -- we are committed to Millennium Development Goal 4 of reducing child mortality by two-thirds by 2015. However, this will require reaching children in the poorest communities, creating a demand for better health services, and removing obstacles to high-quality health services for those who want them.
While effective methods exist to prevent and treat the leading causes of these deaths, knowledge of preventive behaviors and access to preventive interventions -- such as handwashing with soap for diarrhea, vaccines for pneumonia, and bed nets for malaria -- are often lacking. Many families do not recognize the value of preventive behaviors and solutions, do not have access to health facilities where they can receive these life-saving interventions and, even where such facilities exist, they are rarely adequately staffed with capable and fully empowered health workers and stocked with the right commodities.
One way to meet this great need is to continue investments in frontline health workers (FHWs), who can deliver these solutions close to home. Every three seconds, a child's death is prevented in the developing world thanks to an FHW. Meeting the current global need for at least one million additional FHWs could save many more lives. FHW can also deliver Integrated Community Case Management (iCCM), another effective strategy for combating leading child killers, as it brings services closer to the community. iCCM offers a platform for key curative and preventive services for leading causes of death among children for poor hard to reach populations. Given the health system constraints in expanding existing or new health facilities, iCCM is effective for reaching under-served and hard to reach communities.
Additionally, malnutrition is an underlying factor in at least 30 percent of childhood deaths. Because sub-optimal infant and young child feeding and malnutrition increase the risk of death, we must promote immediate and exclusive breastfeeding for six months, and appropriate complementary feeding from the age of six months through two years, with continued breastfeeding. We must focus on nutritional care of sick children, and recuperative feeding to reverse weight loss for those who have been ill. All children must have adequate intake of vitamin A, iron, zinc and iodine, and we must work to integrate family planning with nutrition and health services to reduce stunting.
Today, the Child Survival Call to Action will be held in Washington, D.C. Convened by the governments of United States, Ethiopia and India, and organized in close collaboration with UNICEF, the event will focus on ending preventable child deaths through the survival of newborns, children and mothers. The global health community came together for Child Survival efforts in the 1980s. It is now time to re-energize ourselves, find new champions and end the needlessness, preventable deaths of children under five. We in the public health community applaud the efforts of these leaders, as we envision a future in which the world's most marginalized children receive the same life-saving interventions as our own. Now we must find the political will and determination to make this a reality.
