Unità per la Ricerca sui Servizi Sanitari e la Salute Internazionale (Centro Collaboratore dell’OMS per la Salute materno-infantile), IRCCS “Burlo Garofolo”, Trieste
Key words: Child health, Child survival, Effective interventions, Effective policies, Developing countries
The Author questions the rationale and the conclusions of the series of 5 articles published by The Lancet on child survival. Two main arguments are made. The first is that the international community cannot identify child survival as the only objective: the burden of disability, ill health, violence, abuse and exploitation that children in poor countries have to suffer is as unacceptable as premature death. Second, interventions that are essentially aimed at reducing deaths do not produce sustainable results unless they are based on broader macroeconomic and social policies addressing the main determinants of ill health, such as poverty, lack of water and sanitation, nutrition and education, particularly of females. Improvements in child health, including marked reductions in child mortality, have been obtained by countries that have invested in redistributive policies. On the contrary, reductions in child mortality based essentially on health programmes have proved to be fragile and short-lived. Child health experts, besides identifying the most effective health interventions and delivery strategies, should clearly indicate to governments and to the international community which is the main road to child heath.
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