10 Steps Toward Child Survival

10 Steps Toward Child Survival

Three Afghan children. {Photo credit: MSH.}Photo credit: MSH.

About 7.6 million children under age five die each year of preventable causers; 3 million — 40 percent — are newborns (under 28 days old). Ninety-nine percent of these occur in developing countries; three-quarters are mainly due to preventable causes such as neonatal conditions, pneumonia, diarrhea, malaria, and measles. Many of these under-five deaths could be averted by known, affordable, low-technology interventions.

Any preventable child death is one too many.

Here are 10 important interventions for child survival --- a list that is by no means exhaustive:

  1. Exclusive breastfeeding

    Could keep 1.3 million infants from dying (including by preventing pneumonia)

  2. Long-lasting, insecticide-treated bednets

    Would save more than 500,000 children by preventing malaria

  3. Vaccines, such as PCV, Hib, and rotavirus

    Would help prevent common childhood illnesses, such as measles, and save children’s lives

  4. Micronutrient supplements, such as vitamin A and zinc

    Would fight malnutrition. (While not a direct cause of death, malnutrition contributes indirectly to more than one-third of these deaths.)

  5. Integrated community case management (ICCM) of childhood illness

    Including oral rehydration salts (ORS with zinc) and antibiotics --- to manage malaria, diarrhea and pneumonia and prevent childhood deaths

  6. Family planning and maternal health

    Women must have knowledge and access to family planning services to time and space pregnancies. When they do choose to become pregnant, they must have quality antenatal care, obstetric and delivery services, and post-delivery care, including addressing postpartum hemorrhage and pre-eclampsia and eclampsia management.

  7. Option B+ for prevention of mother to child transmission (PMTCT) of HIV

    The B+ option -- putting pregnant women on ART for life, regardless of the level of HIV in her body -- recognizes mothers’ indispensable role in child survival not only during her pregnancy but also throughout her child’s life.

  8. Address newborn mortality

    Through expansion of health facility-based care, better use of skilled birth attendants, and inclusion/involvement of frontline health workers, to address preterm birth, asphyxia, healthy baby breathing and newborn sepsis

  9. Safe drinking water and improved sanitation

    Basics for reducing common childhood illnesses, such as diarrhea

  10. Amoxicillin

    Would help prevent and treat pneumonia, the leading cause of child deaths worldwide (1.4 million annually)

What are your 10? What interventions are you or your community using? Add your comment below.

Sara A. Holtz, DrPH, MPH, contributed to this post.

Ciro Franco, MD, MPH, is country lead and global technical lead of maternal, newborn, and child health, at Management Sciences for Health.