Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Examining the evidence of under-five mortality reduction in a community-based programme in Gaza, Mozambique

TitleExamining the evidence of under-five mortality reduction in a community-based programme in Gaza, Mozambique
Publication TypeJournal Article
Year of Publication2007
AuthorsEdward, A, Ernst, P, Taylor, C, Becker, S, Mazive, E, Perry, H
JournalTransactions of the Royal Society of Tropical Medicine and Hygiene
Date PublishedAug
ISBN Number0035-9203; 0035-9203
Accession Number17482222
KeywordsChild, Child Mortality/trends, Child, Preschool, Community Health Services/statistics & numerical data, Community Networks, Female, Humans, Infant, Infant Mortality/trends, Infant, Newborn, Male, Mozambique/epidemiology, Patient Acceptance of Health Care, Pregnancy, Pregnancy Complications/epidemiology

Effective implementation of programmes with the community Integrated Management of Childhood Illness model has demonstrated improvements in care-seeking behaviours and utilisation of health services. The child survival programme implemented in Chokwe district of Gaza province, Mozambique, achieved high coverage for bed net use (80%), oral rehydration therapy for children with diarrhoea (94%) and prompt care-seeking from trained providers for children with danger signs. The project also instituted a community-based vital registration and health information system for routine surveillance of births, deaths and childhood illnesses using an extensive network of 2300 volunteers. Evidence from this system indicated a 66% reduction in infant mortality and a 62% reduction in under-five mortality. To check the reliability of the findings, an independent mortality assessment was carried out using a pregnancy history questionnaire with a sample population of 998 women using standard methodologies applied in the Demographic and Health Surveys. The mortality survey showed reductions of 49% and 42% in infant and under-five mortality, respectively. The leading causes of death identified by verbal autopsies were malaria (30%), neonatal causes (17%) and pneumonia (21.3%). These findings suggest that effective community-based partnerships that support the delivery of health services can contribute to mortality reductions.