
This blog post expands on comments that Jennifer Requejo made at MOMENTUM and the Child Health Task Force (CHTF)’s live event on September 16, 2024. Dr. Requejo is a senior scientist at the Johns Hopkins Bloomberg School of Public Health and a Senior Monitoring and Evaluation specialist at the Global Financing Facility for Women’s, Children’s, and Adolescents’ Health. She supports the Countdown to 2030 and Global Financing Facility partnership.
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At the World Health Assembly in May, the newly passed Resolution 11.7 reaffirmed a global commitment to achieving maternal and child health goals. Following are some perspectives from advocates and implementers from countries on what it takes to improve child health.
There has been considerable progress in reducing child mortality in the past two decades. In 2022, global child deaths dropped below five million for the first time. However, this success is overshadowed by persistent inequalities. A staggering 57% of child deaths occurred in sub-Saharan Africa, and another 34% in South Asia. The reality remains grim for children in low-income countries who are 13 times more likely to die before their fifth birthday than those in high-income countries. Moreover, nearly half of these deaths occur in fragile, conflict-affected areas, making it clear that where a child is born still heavily influences their chances of survival.
The event’s discussions revealed that many of the leading causes of child mortality — pneumonia, diarrhea, malaria, and malnutrition — are preventable and treatable with existing health interventions. There is an urgent need to scale up primary healthcare (PHC) initiatives, such as the Integrated Management of Childhood Illness (IMCI) and Integrated Community Case Management (ICCM), both proven strategies that could save countless lives. Despite their effectiveness, these interventions have not reached the coverage levels needed in many regions.
Immunization efforts are another area of progress, with global coverage now surpassing 80%. Yet millions of children, particularly in urban slums and remote rural areas, still miss out on these life-saving vaccinations. In addition to the gaps in healthcare, nutritional challenges persist. Although stunting levels have decreased globally, 148 million children were still affected in 2022, with 95% living in Asia and Africa. The growing threat of malnutrition, particularly child wasting, affects an estimated 45 million children, elevating their risk of death. The World Health Assembly’s renewed commitment to maternal and child health, combined with initiatives like the Community Health Delivery Partnership, aims to expand access to critical services in low- and middle-income countries. It is necessary to address these challenges through a multisectoral approach — improving water, sanitation, and nutrition services alongside healthcare to ensure comprehensive child survival efforts.
We heard from countries like Ethiopia, which has halved its child mortality rates since 2000. The secret? An integrated approach, blending health interventions with economic growth, multisectoral collaboration, and a robust community health worker program. Ethiopia’s success story offers valuable lessons for other nations struggling to meet child health targets: coordinated efforts, data-driven policies, and resilient health systems are essential ingredients for progress.
We also heard about Niger’s community level approaches to addressing malnutrition: awareness and education, particularly through community gatherings, mobile caravans reaching diverse village leaders and residents, and initiatives to help income-generating activities. Sierra Leone’s challenges in reducing child mortality stem from the fragmented approach to child health, where various programs operated in silos without a central coordinating body. Dr. Lynda Farma-Grant, Programme Manager for Child Health in Sierra Leone emphasized the need for a holistic, life-stage approach to child health, that encompasses all aspects of a child’s life starting from pregnancy. She called for alignment of investments across various sectors, emphasizing that funding should not be limited to specific diseases but should encompass broader health issues, including malnutrition, quality of care, and infrastructure.
The conversation reinforced that the fight to reduce child mortality is far from over. The discussions highlighted the need for multisectoral collaboration among health, education, nutrition, and social services. Effective data utilization emerged as a cornerstone for informing policies and targeting interventions, ensuring that programs are tailored to address specific community needs. Active involvement of local communities and leaders is essential for fostering ownership and relevance in health initiatives, particularly in reaching marginalized and underserved populations. With global momentum building and a clear path forward, we can ensure that every child, regardless of their circumstances, has access to the essential services they need to survive and thrive.
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