Health leaders in the Americas adopted a strategy and plan of action for integrated child health, which includes measures to prevent and reduce the burden of disease in children under 5, improve child nutrition, and build capacity among different health institutions and other sectors to improve integrated child health.
Photo credit: PAHO/El Salvador
The strategy was adopted by ministers of health from throughout the Americas during the 28th Pan American Sanitary Conference, held last week at the Pan American Health Organization/World Health Organization (PAHO/WHO) in Washington, D.C.
From 1990 to 2010, deaths of children under 5 in Latin America and the Caribbean declined 54 to 23 per 1,000 live births, an average annual decline of 4.3%. If this trend continues, the region will achieve the Millennium Development Goals (MDG) target of a two-thirds reduction in under-5 mortality by 2015.
However, regional averages in under-5 mortality mask major disparities between and within countries. For example, in 2011 Haiti and Bolivia reported 87 and 51 deaths of children under 5 per 1,000 live births, respectively, compared with 19 per 1,000 in Colombia, 8 in Chile, and 6 in Cuba. The majority of childhood deaths are preventable. In countries with high mortality, selected high-impact, low-cost interventions could reduce the number of deaths by more than 50%, but these interventions do not reach everyone.
Disparities are clear in other child health indicators as well. Although the prevalence of malnutrition at the regional level is low, chronic malnutrition—indicated by low height-for-age—remains one of the most common growth disorders in Latin America and the Caribbean, with nearly 9 million children suffering from this condition. In addition, child obesity is one of the most complex challenges facing public health in several countries.
The new strategy considers child health to be the result of interaction between factors related to health systems and social determinants of health. Addressing these factors requires efforts across social and governmental sectors.
The new strategy calls for establishing a Regional Alliance for Integrated Child Health to strengthen partnerships and collaboration among international organizations, promote health interventions and mobilize resources with national partners. It also calls on each country to convene a National Intersectoral Working Group for Integrated Child Health to develop actions consistent with each country’s policies, laws, epidemiological profile and health systems.
The strategy also calls on countries to:
- Promote the implementation of effective, evidence-based interventions to prevent child illness and deaths.
- Support integrated child health policies as part of overall national health plans.
- Strengthen health systems and health services so they can provide quality care.
- Promote coordination between ministries and other public and academic institutions, as well as between the public and private sectors and civil society, to reach consensus on integrated child health services.
- Build the capacity of health personnel in facilities for integrated primary health care for children.
PAHO/WHO, through a technical advisory group, will support countries in implementing the strategy, in collaboration with other international agencies and sectors. The Organization will also promote national and local partnerships with international agencies, scientific and academic institutions, nongovernmental organizations, and the private sector, among others.
PAHO, which celebrates its 110th anniversary this year, is the world’s oldest international public health organization. It works with all the countries of the hemisphere to improve the health and quality of life of the peoples of the Americas and serves as the WHO Regional Office for the Americas.