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The "Healthy Children: Goal 2002" initiative promotes this IMCI strategy, through which PAHO and other agencies will help train health workers and caregivers to prevent deaths in children under 5 years of age in the Americas 
This effective, low-cost strategy for improving the quality of child health and health care in health facilities, households and communities relies on simple public health interventions, preventive measures taken at home, early diagnosis, effective treatment, and strengthening health systems to reduce the risk and consequences of childhood illness. Every year more than 200,000 children under 5 years of age die in the Region of the Americas from illnesses that can be easily prevented or treated. Acute respiratory infections, diarrheal diseases, and malnutrition are the three leading causes of illness and death in this age group. These diseases and others, such as those caused by intestinal parasites, vaccine preventable diseases and malaria, are the primary reasons for medical consultation and hospitalization. 
Representatives from UNICEF, the World Bank, the Inter-American Development Bank Catholic Relief Services, the Spanish Agency for International Cooperation, and WHO, also pledged backing for the effort, and all participants signed a declaration of support for the Healthy Children, Goal 2002 Initiative. Mark Schneider, Assistant Administrator of the U.S. Agency for International Development, said "This meeting is the start of an important journey to 2002 that can have a dramatic impact on the 100,000 children we can save with our efforts." According to Dr. Yehuda Benguigui, PAHO's regional advisor in Integrated Management of Childhood Illnesses, sick children are often misdiagnosed and treated incorrectly, even by some doctors. Three of every four children taken to a health service in Latin America suffer from one or more of a group of diseases that we know how to control: acute respiratory infections, diarrhea, malnutrition, malaria, and measles, he said. In developing countries, seven of every 10 deaths of children are due to one or more of those diseases and worldwide, 12 million children die every year from these diseases. In many cases, opportunities to treat children's health problems are missed because health workers only focus on the specific, immediate problems and ignore other potentially dangerous conditions, according to Benguigui. 
But now cases are beginning to be handled differently, stemming from the innovative IMCI approach that combines effective measures to control common childhood diseases. By giving the right information to the right people at the right time, Benguigui said, IMCI is already saving children's lives in many countries in the Americas. The IMCI approach is simple and practical. Primary health care workers are taught a complete process to evaluate the health status of children brought to a health post or clinic. They learn to recognize signs of disease and evaluate and treat them. They learn to give parents information on how to prevent disease in the home. If they see danger signs indicating the infant could die, they are taught how to treat the child immediately or take him or her to a hospital. The majority of children who die, Benguigui noted, die needlessly and could have been saved if they had received timely, adequate treatment. Furthermore, these common diseases are relatively easy to treat. For pneumonia, antibiotics can effectively treat most cases. For diarrhea, oral rehydration salts can save a child from dying of dehydration. Basic education on proper nutrition and promotion of breastfeeding can avoid many malnutrition problems. Vaccines, vital to avoid measles and other diseases, are available at health centers daily, and a series of low-cost tablets can protect children from malaria in zones where that disease occurs. These techniques are being taught from materials developed by PAHO in conjunction with WHO, UNICEF, and the U.S. Agency for International Development (AID) through its BASICS (Basic Support for Institutionalizing Child Survival) project. Regional courses have been held in Peru, El Salvador, Brazil, and other countries. Benguigui said a massive effort is currently under way to reach every health worker in the Americas with this information--either by providing the teaching materials or the training, or both, thus forming a network spanning the Americas. However, more funding is needed to reach this goal, he said. During the two-week PAHO basic course, for example, health workers learn to look for tell-tale symptoms for a variety of childhood diseases and then follow a series of simple evaluation and classification charts to determine how serious the illness is. The charts are color-coded: red means the child's condition is urgent and requires hospitalization; yellow and green indicate the problem is less serious and can usually be treated in the health center or at home. Along with the courses, PAHO also has developed and distributed training modules, posters, and videos. The Pan American Health Organization, founded in 1902, works with all the countries of the Americas to improve the health and raise the living standards of their peoples. It serves as the Regional Office of the World Health Organization, and has offices in 27 countries in Latin America and the Caribbean as well as nine scientific and technical centers apart from its headquarters in Washington, D.C. |
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Dr. George Alleyne, Director of PAHO, joined by First Ladies, Ministers of Health, and other partners from international and non-governmental agencies for the launching, said the aim is to save lives by increasing the application of a relatively new strategy called Integrated Management of Childhood Illness, or IMCI. Addressing more than 100 people at the launching, Dr. Alleyne said, "This is an ambitious goal but a feasible one. The strategy is a powerful approach for reducing mortality and morbidity."