Diarrhea, pneumonia and malaria are responsible for nearly half of all deaths in children under 5 years of age in Africa and Asia. MCHIP recognizes that nearly two-thirds of these deaths can be prevented through the provision of simple, inexpensive, cost-effective preventive and case-management interventions—including those addressing malnutrition, which is an underlying factor in at least 30% of childhood deaths. However, reaching children in the poorest communities of the poorest countries remains a challenge. More equitable efforts are needed because these children receive less health care and have higher mortality rates than children from wealthy households.

Vision
MCHIP is committed to Millennium Development Goal 4 (MDG 4) of reducing child mortality by two-thirds by 2015, and works with partners at the global, national and local levels to expand access to preventive and case management interventions aimed at saving children’s lives. The Program works to advance USAID’s effort to expand access to high-quality services based on proven interventions to children in hard to reach areas. Building on lessons learned from partners and predecessor projects, MCHIP focuses on an integrated package of key interventions including the introduction and expansion of integrated community case management (iCCM) of death—namely malaria, pneumonia and diarrhea.

Priorities
Effective methods exist to prevent and treat diarrhea (low osmolarity Oral Rehydration Salt [L-ORS] and zinc), antibiotics for pneumonia, and now artemisinin-combination therapy (ACT) for malaria. Knowledge of preventive behaviors and access to preventive interventions may be lacking—such as handwashing with soap for diarrhea, vaccines for pneumonia, and bed nets for malaria. Many families lack access to health facilities where they can receive these life-saving interventions and, even where facilities exist, they are rarely adequately staffed with capable and fully empowered health workers.

As a result, MCHIP priorities in child health are:

1. Introducing and expanding community case management  of pneumonia (ARI), diarrhea and malaria  (and related approaches that bring services closer to the population); and 
2. Revitalizing and expanding use of Oral Rehydration Therapy (ORT) and zinc for improved diarrhea case management.

Global Leadership
MCHIP advocates for zinc availability at the country level and applying the scale-up model to child health interventions for effective program implementation. MCHIP has completed Lives Saved Tool (LiST) analyses on key interventions, which have been incorporated into country-level child health profiles for USAID priority maternal and child health countries. The LiST analyses provide the estimated number of additional lives saved when a given intervention or package of interventions is delivered at a certain level of coverage to the target population. The profiles provide a synthesis of country-specific child health indicators, key issues enhancing or hindering attainment of MDG 4, and policy environment and potential gains (depending on the coverage of a package of high-impact interventions). These child health profiles are used by USAID and MCHIP for advocacy and program planning with country missions and Ministries of Health.