Better co-ordination crucial to help reduce maternal and child illness and death

The first of a series of articles looking at public health in complex emergencies (such as famine, population movement arising from civil conflicts and associated health problems) is published in this week’s issue of THE LANCET.

Authors of the first article conclude that, while many lessons have been learned and improvements made over the past decade, better co-ordination of the nongovernmental organisations providing services is crucial to help reduce maternal and child illness and death.

Peter Salama (USAID, Washington DC) comments: “Major advances have been made during the past decade in the way the international community responds to the health and nutrition consequences of complex emergencies. The public health and clinical response to diseases of acute epidemic potential has improved, especially in camps. Case-fatality rates for severely malnourished children have plummeted because of better protocols and products. Renewed focus is required on the major causes of death in conflict-affected societies—particularly acute respiratory infections, diarrhoea, malaria, measles, neonatal causes, and malnutrition—outside camps and often across regions and even political boundaries. In emergencies in sub-Saharan Africa, particularly southern Africa, HIV/AIDS is also an important cause of morbidity and mortality. Stronger coordination, increased accountability, and a more strategic positioning of non-governmental organisations and UN agencies are crucial to achieving lower maternal and child morbidity and mortality rates in complex emergencies and therefore for reaching the UN’s Millennium Development Goals.”