It is easier to improve the health of a sick child in a healthy community than to keep a healthy child healthy in a community where disease and death is commonplace, indeed rampant.

IMCI

Early results of the Integrated Management of Childhood Illnesses (IMCI) -- basically Polio Plus Plus -- in Tanzania show that childhood mortality drops 43% and infant mortality drops 49%. The estimated number of children dying annually is 10.8 million. Cutting that rate by 43-49% would save over 5 million lives annually.

These results come from areas that have not yet completed implementation. For example, these areas have only 20-30% of children sleeping under Insecticide Treated Nets. Results typically improve over time as more health care workers are trained and as the healthy cycle strengthens.

Likewise, studies show that results improve as implementations are rolled out and strengthened. Furthermore, they show that improvement in health status is cumulative, that effects improve over time.

It is easier to improve the health of a sick child in a healthy community than to keep a healthy child healthy in a community where disease and death is commonplace, indeed rampant.

IMCI has been adapted in over 70 countries as of early 2004.

Cost of IMCI is estimated at 80 cents per person per year. This figure is worst case. The worst case includes significant up-front training costs and downtime. The results reported above may prove to also be 'worst case', in other words, things should improve cumulatively over time as well.

According to "The Effect of Integrated Management of Childhood Illness on Observed Quality of Care of Under-Fives in Rural Tanzania. Health Policy Plan. 19:1-10":

The results [of the survey] indicate that children in IMCI districts received better care than children in comparison districts: their health problems were more thoroughly assessed, they were more likely to be diagnosed and treated correctly as determined through a gold-standard re-examination, and the caretakers of the children were more likely to receive appropriate counselling and reported higher levels of knowledge about how to take care of their sick children.

Management of Childhood Illness in Africa
BMJ Journal Editorial