Maternal, newborn, child and adolescent health

Strategic review of child health worldwide analyzes past lessons to chart the way forward

Over the past quarter century, child mortality has more than halved, dropping from 91 to 43 deaths per 1000 live births between 1990 and 2015. Yet in 2015 an estimated 5.9 million children still died before reaching their fifth birthday, most from conditions that are readily preventable or treatable with proven, cost-effective interventions. A new WHO-led report, Towards a grand convergence for child survival and health, shares analysis from 20 years of implementation of child health strategies and what steps are needed to ensure each child can survive and thrive.

A young girl sits with her arm around an infant.
Partha Sarathi Sahana

The Review took as its departure point the implementation of Integrated Management of Childhood Illness (IMNCI), developed by WHO and UNICEF in 1995 as a premier strategy to promote health and provide preventive and curative services for children under five in countries with greater than 40 deaths per 1000 live births. Over 100 countries have adopted IMNCI and implemented to varying degrees its three components: 1) improving health worker skills, 2) strengthening health systems and 3) improving family and community practices.

The Review includes contributions from over 90 countries and hundreds of experts in child health and related areas, with 32 specifically commissioned pieces of analysis. The final product represents a collaboration of child health experts worldwide, working together to examine past lessons and propose an agenda to stimulate momentum for improving care for children.

All countries have committed to reducing under-five mortality to 25 or less and newborn mortality to 12 or less per 1000 live births by 2030. These targets are ambitious yet achievable, provided there is political will, adequate investment and concerted action. The Review provides direction to the global child health community on how to better assist countries to deliver the best possible strategies to help each child survive and thrive.

What is IMNCI

IMNCI is an integrated approach to child health that focuses on the well-being of the whole child. IMNCI aims to reduce death, illness and disability, and to promote improved growth and development among children under five years of age. IMNCI includes both preventive and curative elements that are implemented by families and communities as well as by health facilities.

  • improving case management skills of health-care staff
  • improving overall health systems
  • improving family and community health practices.

In health facilities, the IMNCI strategy promotes the accurate identification of childhood illnesses in outpatient settings, ensures appropriate combined treatment of all major illnesses, strengthens the counselling of caretakers, and speeds up the referral of severely ill children. In the home setting, it promotes appropriate care seeking behaviours, improved nutrition and preventative care, and the correct implementation of prescribed care.