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Abstract:
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The 2003 Lancet paper on child survival reviewed interventions feasible for delivery at high coverage in low-income settings. It showed that if key interventions were universally available, over 60% of then current global under-5 deaths could be prevented. Furthermore, while health facility-centric interventions are necessary, household-based interventions, with limited need for external material inputs, could prevent over half these deaths. This is the theory, what is the practice? A child survival project in four countries in West Africa serves as the basis for assessing the situation, not only in terms of intervention coverage and mortality measures, but also the more qualitative aspects of people motivation and management, logistics, adaptation to local conditions, and impact on policies. Some of the challenges of interpreting such information are considered.
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