Reducing Childhood Deaths and the CHOP Global Health Program

Every day at 4 p.m., after her work ends at the community health center, Ramona Cordero heads out on foot into the barrios of the town of Consuelo in the Dominican Republic. Ramona visits the homes of children in The Children’s Hospital of Philadelphia's vaccination program, reminding mothers to bring their children into the clinic to complete their vaccination schedule. Most of the families she visits have a very limited education and are living in extremely impoverished conditions. However, through the outreach work of Ramona and her staff of community health workers, nearly all of the children in the program are fully vaccinated according to the Dominican Republic immunization schedule, a feat that seemed almost impossible two years ago when the program began in the barrios.

By developing partnerships with local organizations, CHOP began a children’s health program called Niños Primeros en Salud, in a rural town in the Dominican Republic in 2009. Delivering timely immunizations to all children under the age of 5 is a priority of the center along with offering other preventive care, a nutrition initiative, de-parasite efforts, breastfeeding education and health education. Immunizing children in the program is such a priority because of the life-saving potential of vaccines, both in the Dominican Republic and throughout the world.

Reducing childhood deaths, the big picture

In 2000, world leaders set eight ambitious goals to reduce poverty around the globe by 2015. One of these goals, known as Millennium Development Goal (MDG) #4, is to reduce childhood deaths by two thirds, and is of particular importance to the health of children. The success of this goal is measured by three indicators:

• Reducing the number of children less than 5 who die each year
• Reducing the number of babies who die each year
• Increasing the number of 1-year-olds immunized against measles

The good news is that for the first time in history, the number of children dying every year has fallen below 10 million. The bad news is that nearly 8 million children will still die before their fifth birthday, largely because of preventable illnesses like pneumonia, diarrhea, malaria and measles. Two million of these deaths, primarily from pneumonia and diarrhea, could be prevented through the use of vaccines.

Immunizations

Immunizations are one of the most effective public health interventions available for decreasing the number of deaths each year in children less than 5. Vaccines are also very cost effective. For the price of a cup of coffee, a child in the developing world can be immunized against five killer diseases. As routine immunizations in many countries throughout the world are becoming more available, they are often delivered to children as a part of packages of interventions that include malaria nets and Vitamin A supplements, which also increase childhood survival rates.

Still, more than 23 million children are not up to date on their immunizations every year due to barriers such as inaccessibility of vaccines, low public awareness of the need for vaccines or unfounded fears about vaccine safety. These unique challenges make it difficult to achieve and maintain immunization rates in developing countries and are the reason global health programs, such as the vaccine program supported through CHOP Global Health, are so important. To learn more about vaccine delivery around the world, visit the GAVI alliance website.

Local dedication, big results

Ramona’s dedication in the Dominican Republic is an example of how innovative programs can overcome the barriers that often prevent successful immunization efforts in the developing world. By improving immunization rates in children throughout the world through programs like Niños Primeros en Salud, more children can be saved and the Millennium Development Goal of reducing childhood deaths will become a reality.

Visit the CHOP Global Health website to learn more about their work.