This month, USAID's flagship Maternal and Child Health Integrated Program (MCHIP) joins countries around the world in celebrating International Children's Day. While great strides in child survival have been made in the past years, we also remember those children who do not live to see their fifth birthday -- the 7.6 million children who die of preventable causes each year.
Pneumonia is the leading cause of death in children under five, killing 1.4 million children each year, more than tuberculosis, AIDS, and malaria combined. While childhood deaths from pneumonia are rare in the developed world, in many low-income countries -- particularly those in South Asia and Sub-Saharan Africa -- childhood pneumonia is often fatal. Most notably, pneumonia highlights the inequities in both disease burden and access to timely health care, as most children who die of pneumonia are malnourished, impoverished or have poor access to health care.
Despite known, effective ways to protect, prevent and treat the condition, pneumonia still accounts for 18 percent of childhood deaths globally. Children can be protected from pneumonia through behavioral interventions such as adequate nutrition during childhood, hand washing, and reducing indoor air pollution by using improved, well-ventilated stoves. However, while these interventions are straightforward, culturally appropriate education for behavior change on these subjects needs to be increased in low-income countries.
Pneumonia prevention utilizes specific vaccinations for pneumococcus, Haemophilus influenzae type B disease, measles and whooping cough. Although these vaccines are efficacious and available, the current vaccine does not protect against all serotypes of pneumonia, and 100 percent eradication can never be realized. MCHIP has assisted countries in developing communication strategies to explain that life threatening acute respiratory infections cannot be fully prevented by vaccination, and through advocating for continued treatment of pneumonia in addition to scaling up access to and use of prevention techniques.
Bacterial pneumonia can be treated with antibiotics if care is sought early; however, globally, only about 30 percent of infected children receive the antibiotics they need at the right time and right dose and duration. With low cost, standardized treatments available, a decrease in pneumonia cases and fatalities can be realized through strategies targeting children outside of the standard health system.
MCHIP has become a leader in expanding treatment of pneumonia to these children through the practice of community management of pneumonia cases. Community Case Management (CCM) is an integrated platform to offer community-based management of childhood illness (often diarrhea, malaria and pneumonia) using either paid or volunteer village health workers. These health workers are trained and supported to assess, classify and treat children, and to refer those with severe illness.
Because village health workers may need specific government policy to prescribe antibiotics and other medications to their pneumonia patients, MCHIP advocates on their behalf to governments and local physician professional groups. CCM is an effective way to deliver antibiotics outside of health care facilities in regions where access to formal health care providers may be limited. By utilizing CCM, families living far from formal health facilities can access life-saving antibiotics in a timely manner while avoiding costly and lengthy trips to the hospital.
MCHIP also provides support for improving the quality of care of facility-based health services. As complicated cases seen by village health workers are referred to these facilities, and village health workers rely on such facilities for training and support, it is essential that both programs work in tandem. At a global level, MCHIP is providing technical leadership in child health and serves as the Secretariat of the global CCM Task Force -- alongside the WHO, UNICEF and other international nongovernmental organizations -- and contributing to the development of a CCM tool kit with programmatic resources to implement CCM, and CCM indicators for effective program monitoring.
MCHIP has demonstrated its commitment to fighting for the lives of the 7.6 million children who die of preventable causes yearly, not only due to pneumonia, but also due to diarrheal illnesses, malaria and HIV. The Millennium Development Goals have added considerable momentum for seeking solutions to decrease child mortality, but we must renew our determination to fight these diseases if we are to reach our 2015 goals.
This International Children's Day, let's celebrate our progress while remaining cognizant of the need to expand our health solutions to the children who are still unable to access effective prevention and treatment against illnesses.
