Maternal, child health programs must reach poorest families to be successful

"Worldwide, evidence-based interventions are being implemented in an effort to drive down child mortality and there are some signs that they are working," a Lancet editorial states. "However, few countries are on course to meet the targets set by Millennium Development Goal 4," the editorial notes. "Most maternal and child health programs do not reach the world's poorest families; it is believed that efforts to do so cannot be successful, cost effective, and equitable," it continues, adding, "Yet if interventions could reach these families, overall nutrition and health would improve and the lives of millions of children could be saved."

"This week, a new Series shows what causes inequities in child health, suggests improvements, and assesses cost-effectiveness," the editorial writes. "In the first report, [UNICEF Chief of Health] Mickey Chopra and colleagues review past studies and conclude that altering intervention delivery in countries of low and middle income can improve coverage," it notes. A second report by UNICEF Health Specialist Carlos Carrera and colleagues "model mortality and stunting outcomes of an equity-focused approach, and find that "[f]or the same investment, a focus on the poorest communities could lead to larger reductions in child mortality and stunting than would a mainstream approach -- especially in countries of lowest socioeconomic status." The editorial concludes, "To make real headway in efforts to reduce child mortality and improve the health and nutrition of all children, policymakers must focus on the poorest and most marginalized families" (10/13).