Basic Support for Institutionalizing Child Survival

MSH President Jonathan D. Quick, age 5. {Photo courtesy of Dr. Quick.}Photo courtesy of Dr. Quick.

Cross-posted on USAID's IMPACT blog

My most vivid early childhood memory is waking up to excruciating pain in my throat, and seeing the goldfish swimming in the aquarium of the pediatric surgical ward. Although penicillin had been discovered 30 years earlier, doctors had not learned yet that treating "strep throats” with penicillin was better than operating. I didn't need the tonsillectomy. But, I was lucky to receive quality care in a health facility, close to my home.

Millions of children today are not so lucky. Over 7 million children under the age of 5 die each year; 70 percent of child deaths occur in sub-Saharan Africa and South-East Asia. The vast majority -- over two-thirds -- are entirely avoidable with existing safe, effective, low-cost prevention and treatment.

This year is not only MSH’s 40th anniversary; it is also 30 years since the first reported cases of HIV. Thirty years ago HIV was considered a new, always-fatal disease. ...Today 6.6 million people—nearly half of those in need—will take life-saving antiretrovirals.

Mother and children, Salima, Malawi, April 2011

Malawi leads the developing world as the first to propose an approach to prevention of mother to child transmission (PMTCT) of HIV that addresses the health of the mother. Recently my MSH colleague Erik Schouten and his colleagues in Malawi wrote a commentary in the Lancet about Malawi’s innovative, public health approach to PMTCT. Malawi calls its model “B+” because it complements the World Health Organization’s (WHO) B option, whereby a mother’s CD4 cell count, a measure of the volume of HIV circulating in her blood, determines her eligibility for lifelong antiretroviral therapy (ART).

Mobilizing communities in rural Benin to improve health.

The West African nation of Benin faces many challenges in achieving Millennium Development Goal 4---reducing child mortality. In the rural communities in Benin (91% of the population live in rural areas), access to health care and treatment is inadequate in relation to the vast need. Very few people have the appropriate skills and capacity to deliver care in these areas. The US Agency for International Development's (USAID) BASICS Benin project is increasing the capability of villages as far as 50 km away from health centers by training Community Health Workers (CHWs) to perform community case management of children five years-old and under.

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