Estimates of the effectiveness of the interventions were taken either from published articles that summarised previous research results or from systematic reviews by the authors or others in the Bellagio Child Survival Study Group. For the latter, the approach was generally to search for original research reports or reviews using MEDLINE, POPLINE, and other databases. The Cochrane database of randomised controlled trials and WHO Reproductive Health Library were also consulted.
SeriesHow many child deaths can we prevent this year?
Section snippets
Identifying effective child survival interventions
Child mortality is the result of a complex web of determinants at many levels.5 Although we recognise the important role played by distal determinants such as poverty and characteristics of the physical environment, we focus here on interventions addressing the more proximal determinants of child mortality and those that can be delivered mainly through the health sector. Interventions that addressed more distal determinants, or that would normally be implemented by sectors other than health,
Current coverage with effective child survival interventions
Table 1 shows estimates of global coverage for the preventive and therapeutic interventions with sufficient or limited evidence of effect on child mortality. These estimates were derived from UNICEF child health data sets2 and other sources (details are available at http://www.childinfo.org/bellagio.htm).53 Coverage rates are fairly high for a few interventions (breastfeeding, measles vaccine), but for most countries and most interventions coverage is low or very low. Haemophilus influenzae
Methods and assumptions
The starting point for this exercise is the 9·7 million children who died in the 42 countries with 90% of the 10·8 million child deaths in 2000.2 For each of these countries, we first calculated how many deaths from a specific cause could be prevented if present coverage levels were increased to universal coverage. Universal coverage was defined as 99% for all interventions except exclusive breastfeeding among children under 6 months of age, for which the target was set at 90%.
Assumptions about
Search strategy
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