Reflect on what you have learned about the history and systems related to infant and child survival.

• If we want to improve child survival, health, and development, is it better to invest in primary prevention programs or tertiary prevention programs? Is it better to invest in general community development initiatives (horizontal programs) or in programs that address specific health concerns (vertical programs)?
• Should the global community shift toward investing ore resource in early childhood development programs, or should the focus continue to be on infant and child survival?

Create a new blog post within the “Blog 5” folder that discusses the one or both of the 2 items listed above. Your best option is to write about ONE of these themes (or a related theme) in depth rather than covering multiple topics superficially.

Your blog entry must be at least 350 words long and use a professional writing style (with correct grammar, punctuation, spelling, and so on). You should include at least one copyright-free image. Read the syllabus carefully so that you know how to avoid academic integrity violations. Include hyperlinks within the text to any external sources that were useful to you as you reflected on the writing prompt and wrote your blog post.

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material:

1. Infant Mortality Epidemiology and Risk Factors: The neonatal period—the first 28 days after birth—is arisky time, with the risk of death especially high on theday of birth. There are some neonatal deaths that arenot preventable, even with the most advanced medicaltechnology. Some newborns have genetic disorders orother congenital defects that are not compatible withsurvival. However, the majority of stillbirths andneonatal deaths in lower-income countries occur because of lack of access to even basicmedical care. Simple interventions like keeping babies warm, breastfeeding them shortlyafter birth, and keeping them clean so that they do not get infections—a challenge when 2women give birth at home on dirt floors—can substantially reduce the risk of death. Theseinterventions do not require advanced technologies, just effective health education.

? Read the neonatal mortality factsheet available from the World Health Organization athttps://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality. Thisis not a formal source, but it provides a foundation for understanding the epidemiologyof neonatal disorders

-Approximately how many newborns (first month after birth) will die this year? Howmany fetuses will be stillborn this year? What percentage of neonatal deaths occurduring the first week after birth? What percentage of neonatal deaths occur duringthe first 24 hours after birth?

-How much did the annual neonatal mortality rate (NMR) decrease between 1990and 2018?What are the major causes of neonatal mortality? Are these preventable and/ortreatable conditions?

-What are the most important newborn care practices?

2. History of Child Survival ProgramsIn 1978, the Alma-Ata conference (held in the citythat is now called Almaty, Kazakhstan) established theimportance of primary health care (PHC) in ensuringthat all of the world’s people had access to “Healthfor All.” Since then, a variety of PHC-orientedinitiatives have been launched by UNICEF, WHO, andother partners. For example, IMCI (the IntegratedManagement of Childhood Illnesses) provides health workers in clinics and in communitybased settings with guidelines for effective and cost-efficient treatment of child healthconcerns. Between 1990 and 2015, the annual number of under-5 child deaths decreased by 3more than half, from about 12.7 million to about 5.9 million. However, that means thatmany thousand young children are still dying every day from preventable causes. Improvinghealth equity for children is one of the major priorities of global health.
? Read the child mortality factsheet available from the World Health Organization athttps://www.who.int/news-room/fact-sheets/detail/children-reducing-mortality.

-About how many children will die this year worldwide? What is the age distributionof the fatalities? Approximately what percentage of these deaths could beprevented with simple, affordable interventions?

-What are the major causes of death for infants and children who are less than 5years old?

-What are the major causes of death for children ages 5–14 years?

? In public health, we talk about three types of prevention.

• Primary prevention includes actions that keep an adverse health event from everoccurring. Primary prevention targets healthy people.

• Secondary prevention detects health problems at an early stage when they havenot yet caused significant damage to the body and can be treated more easily.Secondary prevention targets asymptomatic people.

• Tertiary prevention seeks to reduce impairment, minimize pain and suffering,and prevent death in people with symptomatic health problems.

? Watch this UNICEF video about child health promotion in Sierra Leone:

-What are all of the interventions that are featured in this video?
-Who were the partners for the funding and implementation of this project?

3. Child Health Initiatives in the 21stCentury: Global child health initiatives in the 21st century have shifted fromfocusing merely on survival to promoting interventions that helpchildren thrive. Comprehensive child health programs combinetraditional interventions like vaccinations and nutrition supportwith programs that support psychosocial and cognitivedevelopment, such as early childhood education programs thatprepare children to succeed in school and community-based5therapy programs that help children with disabilities make progress toward achievingdevelopmental milestones.

? Watch this video from UNICEF: What –world region is featured in this video?

-What was the main message of the video?

-What interventions were featured?

-Do you think that it makes sense to invest in early childhood development (ECD)programs in low- and middle-income countries when so many children are still dyingworldwide each year?

-Should the focus stay on survival?

? Global health programs are often described as being horizontal or vertical:

+A horizontal program strengthens an existing healthsystem so that it can deliver additional health services.Horizontal programs are often described as integratingnewly funded packages of health services into existingprimary care delivery systems.

-What are some examplesof horizontal child health programs?

+A vertical program delivers disease-specific services that are not fully integratedinto the health system. Vertical programs are often used to address global healthpriorities like disease eradication efforts that demand an intensive but time-limitedseries of coordinated efforts

– What are some examples of vertical child healthprograms?

-Which type of program do you consider to be most valuable for child survival,health, and development initiatives today?