News — January 01, 2000

Goal 2002

Prevent 100,000 deaths in children under five in the Americas through Integrated Management of Childhood Illness The Pan American Health Organization (PAHO) and the World Health Organization (WHO), in collaboration with other national and interna
Prevent 100,000 deaths in children under five in the Americas through Integrated Management of Childhood Illness The Pan American Health Organization (PAHO) and the World Health Organization (WHO), in collaboration with other national and international agencies, ministries of health and nongovernmental organizations, have proposed the ambitious goal of preventing l00,000 deaths among children under five in the Americas by 2002 using the effective, low-cost strategy of Integrated Management of Childhood Illness (IMCI). Regional Technical Advisor Christopher Drasbek visited the JCI Headquarters to discuss avenues of cooperation between JCI and PAHO. In the past, JCI successfully worked with PAHO at the local, national and international levels on several projects to save children’s lives by promoting the Oral Rehydration Therapy. JCI and PAHO could cooperate now to save children’s lives in the Americas by various means, including: ? Encouraging mutual cooperation by linking websites. ? Sharing communication with NOMs, LOMs and individual members via JCI’s web News, eNews, broadcast mailings and email. ? Promoting cooperation, implementing information campaigns, and running projects locally and nationally to support IMCI’s life-saving projects. ? Carrying out relevant projects that benefit children, generate wide community support and high-profile visibility, and provide powerful recruitment vehicles. ? Providing much-needed manpower for the PAHO campaign. ? Conducting a JCI-PAHO workshop at the 2002 Santo Domingo JCI Area C Conference covering IMCI and promoting successful projects and areas of cooperation. ? Renewing a cooperation agreement between JCI and PAHO at the 2002 Area C Conference. To prevent 100,000 children deaths by 2002, it will be necessary to strengthen the commitment of governments and international agencies to forge strategic alliances with all sectors of society. The problem Every year in the Americas, more than 250,000 children less than five years of age die 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. It is estimated that these diseases cause 60 to 80 percent of the pediatric consultations in health services, and 40 to 50 percent of hospitalizations of children under five. This overwhelming burden of suffering and death occurs in all Latin American and Caribbean countries, but is more serious in countries where infant mortality rates exceed 40 deaths per 1,000 live births. Why do these deaths occur? There are many reasons, including the following: ? Many people do not have access to appropriate preventive information or to health services because of geographical, social, economic, or cultural barriers. ? Parents often lack knowledge of the early danger signs and appropriate preventive measures, and do not seek timely assistance. ? Control efforts are frequently geared toward specific strategies that have been implemented and applied individually, missing opportunities for vaccination and early detection and treatment of diseases that are not the principal reason for a consultation. ? Methods used do not typically educate parents on providing better care for the child through breastfeeding, proper nutrition practices, preventive measures such as vaccination, and promotion of child health through hygiene and stimulation. ? Health workers are often not trained to identify early danger signs of diseases and to provide effective treatment. ? Antibiotics are frequently used in excess, and cough syrups and anti-diarrhea medications often unnecessarily prescribed. Laboratory services are often poor, and results are not always utilized for the diagnosis or treatment of the disease. The solution The Integrated Management of Childhood Illness (IMCI) strategy promotes the improvement of case management skills of health professionals, quality of the health system required for effective management of childhood illness, and family and community practices. The IMCI strategy allows health professionals to take advantage of the child’s visit to a health facility to assess his or her overall health status and identify any problems or disorders. ? It identifies critically sick children who require hospital treatment and improves referral practices. ? It focuses attention on the child’s integrated care, beyond the original reason for the consultation. ? It evaluates the child’s nutritional status, vaccination record, and growth and development, as well as the preventive practices used at home. ? It improves the quality of the health services and the use of those services in the community. IMCI optimizes the use of community resources because: ? It identifies and explains healthy practices in the home, focuses on improving family and community practices important to the child, and provides preventive information to the parents and community. ? It actively involves the participation of the community so that preventive actions to support the well being of the child are taken. ? It adapts to the reality of local health conditions and the operational capacity and cultural realities of each country. Impressive IMCI Statistics Where IMCI has been introduced, the statistics of its impact are impressive. Between 1979 and 1999, comprehensive evaluation for sick children increased from 0 to 93 percent; nutritional evaluation increased from 28 to 88 percent; and evaluation of vaccination status increased from 50 to 95 percent. Mothers are leaving health facilities with more knowledge concerning care of the sick child. The number of mothers knowing how to give oral medications increased from 12 to 49 percent, and those able to identify danger signs, from 7 to 70 percent. Organizations that promote and support the IMCI strategy ? World Health Organization (WHO) ? Pan American Health Organization (PAHO) ? United Nations Children’s Fund (UNICEF) ? U.S. Agency for International Development ? Dutch Cooperation ? Spanish Cooperation ? World Bank ? Inter-American Development Bank ? CORE Group (Association of 32 NGOs) ? American Red Cross ? Save the Children ? Plan International ? CARE ? World Vision ? Catholic Relief Services ? Project HOPE Universities and scientific societies supporting IMCI include Latin American Association of Pediatrics, Baylor College of Medicine, George Mason University, Miami Children’s Hospital, Texas Children’s Hospital, Latin American Association of Nursing Schools, and Pan American Federation of Medical Faculties and Schools. For more information, go to
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