EVIDENCE-BASED INTERVENTIONS AND INNOVATIONS TO ADDRESS CHILD HEALTH INEQUITIES

• Most under-5 deaths can be prevented through proven low-cost interventions.
• Childhood deaths from diarrhea and pneumonia can be prevented through vaccination and exclusive breastfeeding.
• Deaths related to undernutrition can be prevented through proper feeding practices.
• Micronutrient supplementation helps reduce malnutrition-related deaths.
• Community-based screening and management improve outcomes in malnourished children.
• Improving maternal, child, and adolescent health requires a life-course approach.
• Essential health interventions are needed from adolescence through childhood.

HEALTH AND MULTISECTOR ACTIONS

• Ensure food security for families.
• Improve maternal education.
• Provide safe drinking water and sanitation.
• Promote handwashing with soap.
• Reduce household air pollution.
• Provide health education in schools.

ADOLESCENCE AND PRE-PREGNANCY

• Family planning.
• Preconception care.

PREGNANCY

• Appropriate care for normal and high-risk pregnancies.
• Maternal tetanus vaccination.
• Antenatal steroids for premature births.
• Preventive treatment for malaria.

CHILDBIRTH

• Skilled delivery care.
• Maternal monitoring during labor.
• Thermal care for newborns.
• Clean cord and skin care.
• Early initiation of breastfeeding.
• Exclusive breastfeeding from birth.
• Newborn resuscitation when needed.
• Special care for premature and low-birth-weight infants.
• Kangaroo mother care.

POSTNATAL PERIOD

• Regular postnatal visits.
• Extra care for small and sick newborns.
• Early treatment of newborn infections.
• Support adequate feeding.
• Manage respiratory complications.

INFANCY AND CHILDHOOD

• Exclusive breastfeeding for the first 6 months.
• Continue breastfeeding with complementary feeding thereafter.
• Monitor child growth and development.
• Ensure routine childhood immunization.
• Provide micronutrient supplementation, including vitamin A.

PREVENTION OF CHILDHOOD DISEASES

• Prevent malaria through insecticide-treated bed nets.
• Prevent pneumonia through vaccination and preventive care.
• Prevent diarrhea through rotavirus vaccination.
• Prevent meningitis through vaccination.
• Prevent measles through vaccination.
• Prevent mother-to-child transmission of infections.

MANAGEMENT OF CHILDHOOD DISEASES

• Manage severe acute malnutrition.
• Treat malaria appropriately.
• Treat pneumonia with proper case management and antibiotics.
• Treat diarrhea with ORS, zinc, and continued feeding.
• Treat meningitis with appropriate therapy.
• Provide vitamin A in measles.
• Provide comprehensive care for children affected by HIV.

VACCINE-PREVENTABLE DISEASES

• Vaccines save millions of children’s lives every year.
• Vaccination is one of the most effective child survival interventions.
• Many child deaths are still caused by vaccine-preventable diseases.
• Most vaccine-preventable deaths occur in low- and middle-income countries.
• Major vaccine-preventable pathogens include:
  • Streptococcus pneumoniae
  • Rotavirus
  • Bordetella pertussis
  • Measles virus
  • Haemophilus influenzae type B (Hib)
  • Influenza virus
• The WHO Expanded Program on Immunization (EPI) has greatly reduced childhood illness, disability, and death.
• Immunization programs have nearly eliminated poliomyelitis in many regions.
• COVID-19 disrupted routine vaccination services worldwide.
• Reduced vaccination coverage increases the risk of disease outbreaks.

REACHING EVERY CHILD, EVERYWHERE

• Universal coverage of lifesaving interventions remains a major challenge.
• Many children still do not receive proven treatments such as oral rehydration therapy.
• Access to healthcare is influenced by health systems, social factors, and political conditions.
• Strategies to improve coverage include:
  • Community mapping.
  • Quality improvement programs.
  • Integrated service delivery.
  • Better disease surveillance.
  • Strengthening health systems.

EFFECTIVE DELIVERY STRATEGIES: IMCI

• Weak health systems limit delivery of lifesaving child health interventions.
• Common problems include:
  • Shortage of health workers.
  • Poor training and supervision.
  • Weak supply chains.
• Child health services must be integrated across communities, clinics, and hospitals.
• Community outreach services remain essential for improving child survival.
• Community-based interventions are effective, affordable, and improve healthcare-seeking behavior.
• Community Health Workers (CHWs) play an important role in extending healthcare delivery.
• Separate disease-specific programs can result in missed opportunities for comprehensive child care.
• Children often present with multiple overlapping health problems.

INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI)

• IMCI was developed by UNICEF and WHO to reduce child mortality, illness, and disability.
• IMCI promotes healthy growth and development.
• IMCI combines:
  • Health promotion.
  • Disease prevention.
  • Disease treatment.
• IMCI uses standardized clinical algorithms for case management.
• Community Health Workers are trained to recognize common childhood illnesses.
• CHWs identify children needing referral to health facilities.
• CHWs educate families on home management of illness.
• CHWs promote:
  • ORS and zinc for diarrhea.
  • Appropriate treatment of malaria.
  • Antibiotics for pneumonia.
  • Bed-net use.
  • Handwashing.
  • Proper infant feeding.
• IMCI was later expanded to include newborn care and became IMNCI.
• More than 100 countries have adopted IMNCI.
• IMNCI improves:
  • Health worker skills.
  • Health systems.
  • Family and community practices.
• Proper implementation of IMNCI reduces child mortality.
• Successful implementation requires:
  • Strong government commitment.
  • Adequate health systems.
  • Trained community health workers.
  • Reliable medication supplies.
  • Effective referral systems.
  • Support from international partners.

KEY CONCEPT

• Most under-5 deaths can be prevented with low-cost evidence-based interventions.
• Vaccination, breastfeeding, nutrition, sanitation, and early treatment are the foundations of child survival.
• Community-based healthcare is essential for reaching vulnerable children.
• Strong health systems are required to deliver lifesaving interventions effectively.
• IMCI/IMNCI integrates prevention, treatment, and health promotion to reduce child mortality and improve child health.