CHILD SURVIVAL: PROGRES TOWARDS MEETING MDG4

Abstract

Few causes are responsible for the majority of under-five deaths in Ethiopia: pneumonia (28%), neonatal causes (25%), malaria (20%), diarrhea (20%), measles (4%) and AIDS (1%). To prevent these deaths, and to achieve Millennium Development Goal 4 (MDG4) (“to reduce by two thirds, between 1990 and 2015, the under 5 mortality rate”), it is necessary to ensure the implementation of cost-effective interventions that are listed in the National Child Survival Strategy. There are examples of remarkable achievements in coverage increase within short time periods, including training of 30,000 Health Extension Workers (HEWS) in the last 4 years, rapid increase, from 1% in 2005 to 42% in 2007, in percentage of children under the age of five years who slept under a Long Lasting Insecticide-treated Nets (LLINs), and increase in coverage of Vitamin A supplementation from 45 % in 2005 to 91% in 2007. These successes can serve as benchmarks to scaling up of other interventions. Among the major killers, the ones that are poorly addressed are childhood pneumonia and perinatal problems which are the leading causes of under-five mortality in Ethiopia. Realizing the continuum of care approach at delivery level and sustaining it over time, and searching for an alternative way of improving access to treatment of childhood pneumonia and essential newborn care, are crucial challenges for child survival in Ethiopia. Furthermore, there is growing consensus that a primary bottleneck to achieving MDGs in low-income countries is health systems that are too fragile and fragmented to deliver the volume and quality of services to those in need. Major shortfalls are identified in the health workforce, lack of donor coordination, and week information systems. It is for this reason that the Health Sector Development Programme (HSDP) in Ethiopia is focusing on cost-effective health interventions and on health systems strengthening in order to achieve the dual goals of improving population health and reducing health inequalities.