Ending preventable child deaths: investigating and addressing major bottlenecks that impede implementation of cost-effective interventions in resource-poor settings
Thanks in large part to the increased attention to child survival brought about by the Millennium Development Goals (MDGs),the world has made substantial progress in reducing child mortality over the past two decades. The number of deaths among children under 5 years of age has declined from more than 12 million in 1990 to 6.9 million in 2011. However, thousands of children continue to die every day from preventable diseases in low-income and poor areas of middle-income countries. Two-thirds of these deaths are from infectious causes, nearly all of which are preventable through cost-effective interventions such as breastfeeding and vaccination. Although we know where and why those children are dying and have effective interventions to prevent them, we do not always know how to effectively deliver those interventions to those in need. Increasingly, it’s being recognized that program implementations strategies deserve as much careful consideration for effectiveness as the interventions being proposed for implementation. My work on child survival focuses on investigating and addressing major bottlenecks that impede effective implementation; testing new approaches to improve health programming; and determine a causal relationship between the intervention and its impact, particularly in the most resource-constrained settings.
