2014 Partners' Forum
30 JUNE - 1 JULY | Sandton Convention Centre, Johannesburg, South Africa
Session 1B: Building a Future Where Children Survive and Thrive
The session “Building a Future Where Children Survive and Thrive” was attended by government representatives, technical experts, civil society and development partners who were keen to learn about the state-of-the-art evidence on ensuring that children not only survive but also thrive. Dr. Linda Richter, from the Universities of Witwaterstand and Kwazulu-Natal, described how disparities from previous generations are amplified during early life due to variations in protection and risk. She showed how this not only results in poor adult health but erodes human capital, perpetuating the cycle to the next generation. She stressed the importance of protection outweighing risks and pointed out that not only do we have effective interventions, but that there is a high cost associated with inactions. Dr. Richter provided compelling evidence from Guatemala, Jamaica and Brazil showing how early childhood interventions can have long term benefits in LMICs.
A distinguished panel of experts, moderated by Dr. Ana Langer, then discussed how different sectors could work together to expand the gains made in child survival so that the 200 million children under 5 years, who currently do not reach their full potential, are able to do so. H.E. Tan Vuoch Chhen, Secretary of State, Ministry of Health, Cambodia, highlighted how Cambodia invested in key sectors such as education and nutrition to complement health sector investments which has dramatically improved childhood outcomes in the country. Using examples from Zambia and Cambodia, Rebecca Fishman, Director, WASH Advocates (water, sanitation, and hygiene) pointed out how shared advocacy and integrated programs should be central to the post-2015 development agenda, and that WASH is not just an infrastructure issue but is also a health and human rights issue. She quoted a new study coming out in the International Journal of Public Health which identified financial barriers and lack of coordination as major impediments to cross-sect oral collaboration. Strong country leadership and incentivizing collaboration through appropriate funding are ways to overcome poor coordination.
Dr. Daelmans, Acting Director and Coordinator, WHO stated that more children are surviving today than before but unfortunately we are not realizing this dividend in terms of ensuring they are also thriving. She described the Care for Child Development (CCD) package that goes beyond child survival to facilitate and optimize the interaction between care giver and child. She explained how WHO and UNICEF have integrated this package with nutrition and child survival packages at the community health worker level and underlined the commitment of both these agencies to assist countries in tackling frontier.
Dr. Bhutta, Chair in Global Child Health at the Hospital for Sick Children, Toronto; and Director of the Center of Excellence in Women and Child Health, Aga Khan University, spoke eloquently on the latest evidence on childhood development that shows that if we remove constraints around illness, behaviors and risk exposures, children in all parts of the world show similar growth patterns. He rallied the audience to protect, to the maximum extent possible, the 15 million pre-term births not only from death but also lifelong morbidity. He reminded the audience that CHWs have a finite capacity to implement, so we need to be cognizant of what they will need to give up when we add tasks to their workload.
Ms. Chatfield, Project Manager, Maternal Health Task Force asked the group to think beyond programmatic platforms to use ICT platforms to reach adolescents, women etc. with integrated messages, and described how Bangladesh has used ICT to promote MNCH.
There were several interesting questions around the role of multiple stakeholders such as parents and schools in helping children thrive, importance of creating demand for these early childhood interventions, making sure that CHWs are paid for their work (not a cadre of unpaid women who are expected to carry this additional workload) and the importance of involving communities and civil society in holding programs accountable. Dr. Langer mentioned the work that the Women and Health Initiative is doing in examining the role of women as informal and formal health providers and concluded the session by reiterating the importance of taking a life course development approach to identify entry points for early intervention.