Since 2000, the United Nations has celebrated August 12th as International Youth Day, an occasion to promote the lives and contributions youth make to our world. International Youth Day is also an opportunity to recognize global efforts for child survival and early childhood development that are the foundations for healthy youth development and growth. As global child health practitioners and advocates, International Youth Day represents an opportunity to reflect on the ways in which we approach child health.
The global child health community is currently focused on mortality and disease-specific visions
International aid agencies, governments, and civil society spend many resources on one or more aspects of healthcare delivery, targeting disease-specific interventions to end preventable deaths of children under five in sub-Saharan and Asian countries. These efforts focus mainly around strategies such as integrated Community Case Management and Integrated Management of Newborn and Childhood Illness that aim to reduce incidence of the three main killers of young children—pneumonia, malaria, and diarrheal disease—and to a lesser extent on other diseases (such as tuberculosis, HIV, and nutrition, a leading contributor to morbidity in low to middle income countries).
The main objective for all of these stakeholders is to meet Millennium Development Goal (MDG) 4 (reducing child mortality by 2/3 from 1990 to 2015), and subsequently meet post-MDG 4 (reaching a mortality rate of 20/1000 live births per country by 2035). Coordination among donors and disease-specific technical teams is at the heart of expanding healthcare coverage, leveraging resources, and improving the quality of services.
Most recently, the Global Fund encouraged this type of coordination between country-based malaria and child health technical teams through its New Funding Model, which allows applicants the expansion of community case management of malaria to include pneumonia and diarrheal disease as part of their application proposal.
Supporting child growth and development
Child mortality rates do not, however, decline as a sole result of having access to high-impact interventions. In fact, many factors and conditions contribute to the survival of children under five. As reported in Success Factors for Women’s and Children’s Health studies, fast track countries were similar in three ways:
- Multiple sectors were involved in addressing crucial health determinants-about half of the child and maternal mortality rates reduced as a result of development outside of the health sector;
- The health sector engaged partners across society, using timely, robust evidence for decision-making and accountability and created planning approaches that met immediate needs while incorporating, long-term vision and adaptation to change; and
- Guiding principles were agreed upon and used by multi-sector stakeholders to shape governance strategies, align stakeholder involvement and chart progress.1
While Success Factors significantly lent to reducing child mortality in 10 fast-track countries, improved living conditions can also increase the ability for countries, communities and families to engage in and support efforts for child growth and development.
According to UNICEF, while 200 million children survive life threatening diseases, very few of them reach their full potential due to a lack of adequate nutrition, care and the opportunity to learn. Furthermore, UNICEF estimates that a country loses 20% of adult productivity as a result of not investing during the early years when brain development is so crucial.2
Early childhood is when children begin to develop the capacity to learn and build healthy social behaviors and self-esteem. This year’s International Youth Day focuses on the importance of mental health, and it is crucial for the global child health community to work together to create enriching environments where children can be cognitively stimulated and learn, feel safe, and have the capacity to develop and grow.2
The Way Forward
While there is still much to be done in order to increase access to and utilization of lifesaving commodities and services for young children, global child health practitioners and advocates need to ask themselves:
How is the global child health community involved with creating and sustaining conditions at the country, community, and household level for children to physically, cognitively, mentally and socially develop?
This International Youth Day is a time to reflect on how silo-ed efforts can be linked to a much bigger global child health agenda that includes both disease-specific and early child development approaches. It is also a time to reexamine whether we need to develop a new global leadership for child health.
This new leadership will prompt the global child health community to think more broadly; define principles of progress; work towards collective child health outcomes that go beyond disease-related interests and span across all aspects of child health- physical, cognitive, mental, and social; and adapt existing/adopt new strategies and approaches that involve stakeholders from multiple sectors—such as government, education and economic development.
A new global agenda can facilitate and encourage collaborations across sectors to develop and sustain thriving infrastructures that allow countries, communities and households to become:
- Economically stable so children can attend school;
- Environmentally stable to increase access to clean water-reducing a child’s likelihood of developing diarrheal disease, and clean air- reducing indoor air pollution that dramatically increases a child’s likelihood of developing pneumonia or other acute respiratory infections; and
- Politically stable to reduce the likelihood of civil unrest and exposure to conflict that dramatically impacts mental and behavioral development in children and youth.
We should not see disease-related interventions and early childhood development as mutually exclusive. Instead, we should challenge ourselves to view the MDG 4 and MDG 5 (to eradicate extreme poverty and hunger) as part of our global agenda for child health. MDG 4 is not an ends to a means; in fact, it’s just the beginning, the first phase of creating a world where the Convention of the Rights of the Child can be realized.3
It cannot be understated that child health practitioners, program implementers, and advocates have all contributed to saving children from preventable death and sickness by addressing their most immediate disease and illness related needs. But what more should we be working towards?
Children and youth alike thrive in conflict-free, loving, nurturing environments where they feel safe and free to learn and grow. The global child health community needs to take a holistic approach to child health, and not lose sight of the fact that a child’s surroundings impact their health outcome, growth and development. A new global child health leadership means going beyond increasing access to health interventions and addressing the need to work towards improving a child’s environment so they can grow to become physically, cognitively, mentally and socially healthy youth.