MDG #4: Reduction of Child Mortality

The Millennium Development Goal (MDG) #4 seeks to reduce the probability of children dying between birth and 5 years of age by two-thirds (66%) between 1990 and 2015. This issue of The Soul Beat highlights just a few of the ways in which communication strategies can have an impact on child survival rates in Africa.

For more information on the Millennium Development Goal #4 and all of the MDGs, please see The Communication Initiative's MDG - Overview

To learn more about the Millennium Development Goals, you can also visit United Nations Millennium Goals

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DIARRHOEA AND CHILD MORTALITY

1. Mass Media and Health Practices Project - Honduras and Africa
This early 1980's project aims to reduce infant mortality caused by diarrhoeal dehydration in developing countries. The project targeted rural mothers and grandmothers of children under the age of five, as well as primary health care workers. When rural health care workers completed their oral rehydration therapy (ORT) training, a flag was posted at their house to let other mothers in the area know where they could obtain health advice and instruction. The campaign promoted a mother-craft concept in which a mother's current actions and beliefs were supported, with the programme's health techniques position as an added complement to her caregiving regimen. The programme also distributed print materials and ran radio advertisements carrying basic messages related to ORT.
Contact Dr. William Smith bsmith@aed.org

2. Millions Saved - Case 7: Preventing Diarrhoeal Deaths in Egypt
In 1977, diarrhoeal diseases were identified as a major cause of infant deaths in Egypt. This programme set out to distribute oral dehydration salts, along with information about the appropriate treatment of children with diarrhoea, through public and private channels, including mass media avenues such as television. The authors attribute the programme's success to its flexibility: an evaluation component was present from the outset of the programme, and this allowed for corrective interventions during the life of the programme. The diarrhoeal programme was also flexible in that it used and responded to trial and error and feedback from evaluation evidence. Interventions were tested in episode pilots and rehearsals and different elements of the programme were constantly adapted.

3. BASICS Madagascar - Madagascar
In 1995, Basic Support for Institutionalizing Child Survival (BASICS) began a three-year project in Madagascar with the objectives of: building national capacity to develop and implement child survival and nutrition policies, developing district capacity to manage child survival programmes, and promoting sustainable behaviour change for child survival at community and household levels.
Contact Mark Rasmuson MRASMUSO@basics.org

4. Caring for Children in Uganda: A Handbook for Parents of Young Children
This handbook aims to help parents and caregivers look after children aged 0-6 years. It presents clear and easy-to-read steps to assist with healthy pregnancy, breastfeeding and nutrition, basic hygiene, malaria prevention and immunisation, treatment of diarrhoea and other childhood illnesses.

COMMUNICABLE DISEASES, MEASLES AND IMMUNISATION

5. The Case for Childhood Immunization
In this advocacy document, The Children's Vaccine Program (CVP) looks at the past 50 years of vaccines and immunisations. They examine the lack of vaccines in resource-poor countries and the lack of initiative in developed countries - both of which can lead to childhood illness, death, and resurgences of diseases once considered fully eradicated.

6. Immunisation in sub-Saharan Africa - Synopsis Recommendations
This document provides a series of case studies carried out in five sub-Saharan countries: the Democratic Republic of the Congo (DRC), Mali, Mozambique, Nigeria and Zambia. The case studies document communication activities for polio eradication, routine immunisation and surveillance. In addition, the document highlights effective and innovative experiences and provides recommendations for the improvement of communication interventions.

7. Communication Approach for Community Integrated Management of Childhood Illness (IMCI)
The Integrated Management of Childhood Illness (IMCI) strategy was initiated by the World Health Organisation (WHO) and UNICEF to reduce the large number of young children (10 million) in developing countries who die before age five because of vaccine preventable diseases (VPD), malnutrition, and/or AIDS. This paper focuses on IMCI strategy at community level: preventing and managing childhood diseases and fostering children's development in the home and community by involving role-players at national, district, and community levels. More specifically it involves improving the case management skills of health workers, the health system, and family and community practices.

8. Assessment of the Missed Children of the September 2004 National Immunization Day - Egypt
At UNICEF's request, this study was conducted to support Egypt's Ministry of Health and Population (MOHP) national efforts to undertake a stronger communication and social mobilisation campaign aimed at achieving a polio-free country by the end of 2005. This 27-page report presents gaps in knowledge, attitudes, and practices (KAP) and provides a profile of the children who did not participate in the 2004 National Immunization Days detailing misconceptions and refusal reasons.

9. Combating Antivaccination Rumours: Lessons Learned from Case Studies in East Africa
The vaccination programmes of recent decades have, to a certain extent, been the victims of their success. As morbidity and mortality have declined, so, too, has the African public's perception of the importance of some vaccine preventable diseases (measles is a notable exception). In addition rumours and anti-vaccination campaigns have created fears of side effects and long term repercussions of vaccination. The documents offers case studies from Kenya, Uganda, and Tanzania which include an in-depth study of anti vaccination campaigns and interviews with key players said to have spread rumours. The report also assesses the effectiveness of the responses of national and local governments, WHO, UNICEF, and other agencies and officials in combating or stopping the rumours. Additionally, this report seeks to determine whether there is a direct correlation between rumours and drops in vaccination rates and highlights lessons learned from all three countries.

10. Satellife PDA Project - Uganda
This project aimed to demonstrate the viability of handheld computers - also called Personal Digital Assistants or PDAs - for addressing the digital divide among health professionals working in Africa. The Project was conducted in three phases and in the first phase Satellife linked the project to a widespread immunisation campaign being conducted in Ghana by the American Red Cross (ARC) in December 2001. The project used 30 PDAs for field surveys to determine the efficacy of the measles immunisation campaign outreach efforts and to collect some baseline health information. Contact Satellife info@healthnet.org

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HIV and AIDS and PREVENTION OF MOTHER TO CHILD HIV TRANSMISSION (PMTCT)



11. Review of Field Experiences: Integration of Family Planning and PMTCT Services
In 2002 the World Health Organisation (WHO) stated that preventing unintended pregnancy among HIV-positive women through family planning services is one of the four cornerstones of a comprehensive programme for the prevention of mother-to-child HIV transmission (PMTCT). This report commissioned from the Population Council by the WHO reviews field experiences that integrate family planning with PMTCT services in Zambia, Uganda and Kenya. The review aims to provide evidence and information for developing effective strategies for appropriately promoting family planning within PMTCT programmes.

12. Infant Feeding and Counselling Within Kenyan and Zambian PMTCT Services: How Well Does It Promote Good Feeding Practices?
This investigation examined the implementation of infant feeding counselling as part of a study in Kenya and Zambia to document the acceptability, operational barriers and impact of pilot PMTCT services. A particularly challenging component of PMTCT services is providing counselling that promotes good infant feeding practices. This summary presents key findings from the Kenya and Zambia studies on the content of counselling, provides attitudes about infant feeding options, and the extent to which actual infant feeding practice by mothers is consistent with recommended practice. The studies contribute critically needed information for informing policy and program design and for documenting best practices for PMTCT.

13. More than words? Action for Orphans and Vulnerable Children in Africa: Monitoring Progress Towards the UN Declaration of Commitment on HIV/AIDS
This report examines the progress indicators of the United Nations General Assembly Special Services on HIV/AIDS (UNGASS)'s commitment to HIV/AIDS in 2001 which included specific commitments related to orphans and vulnerable children in Ethiopia, Mozambique, Uganda and Zambia. Its findings focus on policies and strategies, education, health, nutrition, psychosocial support, family capacity, community capacity and protection issues. The report includes recommendations.

POLIO

14. Africa's 2005 Polio Eradication Strategy
On January 13 2005, health ministers from Burkina Faso, Central African Republic, Chad, Côte d'Ivoire, Egypt, Niger, Nigeria, and Sudan met at the World Health Organization (WHO) headquarters in Geneva to develop and discuss a polio eradication strategy for 2005. Partners found that, following resumption of polio immunisation social mobilisation campaigns and activities (which were synchronised across 23 African countries), 80 million children have been reached and the epidemic is being reined in. Inspired by these trends, the ministers decided to embark on a "massive series of immunization campaigns across 25 countries". The meeting signalled a recognition of the importance of using community mobilisation strategies to motivate behaviour change in the area of polio vaccination.

15. Polio Eradication Immunisation Campaign - Ethiopia
In 2005, the World Health Organization (WHO), the Federal Ministry of Health, and the Regional Health Bureau developed plans to mount emergency immunisation activities to prevent further spread of Wild Polio Virus (WPV) in Ethiopia. A house-to-house eradication campaign is supported by advocacy drawing on the participation of high-level political leaders and the media, as well as community-based awareness and mobilisation activities. The aim is to immunise 15.5 million children under the age of 5 against polio, thus containing its spread within the country.

16. Capacity Building in Communications: An Examination of the Polio Eradication Initiative
It has been widely acknowledged that communications and social mobilization efforts have made an important contribution to the eradication of polio in Africa. The increased deployment of people involved in communication and social mobilisation has created the need for capacity building in the field of communications. This report reviews the capacity-building efforts in communications related to polio eradication and includes lessons learned regarding the best strategies for capacity building and recommendations to polio/immunization partners.

17. Update of Polio National Communication Plan 2004- 2005 – Egypt
In June 2004, a group of independent communication and epidemiological experts met in New Delhi, India to present to each of the polio-endemic countries their recommendations for improving the effectiveness of their polio social mobilisation/communication programmes. Experts reviewed the effectiveness of the strategies implemented so far, their link to epidemiological data, the plans until the end of 2005 and suggested recommendations. In early 2004, Egypt's Ministry of Health and Population (MOHP) had approved a national, UNICEF-supported communication plan for polio. This 27-page review presents a revision of the MOHP's polio social mobilisation plan, based on the expert recommendations.

MALARIA

18. Bringing Down Mosquito Fever - How NGOs Promote Home-Based Treatment of Malarial Fever in Uganda
Home based management of fever due to malaria is considered a simple and effective response to malaria as it teaches mothers to identify the signs and symptoms of malaria and provides them with easy access to appropriate drugs. This document is the result of a 14-day qualitative methods and "field story" writing workshop sponsored by Malaria and Childhood Illness NGO Secretariat (MACIS) in May 2004. The document highlights questions about home-based treatment of malarial fever raised by workshop participants which included staff members of the Adventist Development and Relief Agency International, Africare, AMREF, Christian Children's Fund, Minnesota International Health Volunteers,THETA, Uganda Red Cross Society, and World Vision.

19. Net Gain - A New Method for Preventing Malaria Deaths
According to this publication a finely spun net could prevent as many as one-third of all child deaths in Africa. Studies conducted in The Gambia, Ghana, and Kenya show that the insecticide-treated mosquito net reduced the mortality rate of children under 5 years of age by up to 63 percent. The publication reviews and discusses the development of the treated mosquito net, focusing on the technology, its implementation, and its promotion.

20. Social Marketing of Bednets in Tanzania
The document looks at the Tanzanian social marketing programme, known as KINET, for insecticide-treated nets in two rural districts of Tanzania, Kilombero and Ulanga, implemented by Ifakara Health Research and Development Centre (IHRDC). KINET aims to achieve substantial and sustainable use of insecticide-treated nets in young children and pregnant women. The document discusses how this is achieved through the social marketing strategy which focuses on promotion, distribution and targeting most-at-risk groups.

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The Soul Beat seeks to cover the full range of communication for development activities. Inclusion of an item does not imply endorsement or support by The Partners.

Please send material for The Soul Beat to the Editor - Anja Venth aventh@comminit.com

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