Arusha - Africa must rapidly accelerate efforts to improve access to, and the quality of health services for children to save more children’s lives and achieve sustainable development.

Prompted by the alarming limited progress, WHO with UNICEF and USAID brought together experts in child health in Arusha from 14-17 February to rethink and devise sustainable solutions to barriers that are holding back progress for the health and development of children.

Bringing together child health experts from ministries of health on the continent, the consultative meeting examines progress and lessons from implementation of the Integrated Management of Childhood Illness Strategy (IMCI) developed by WHO and UNICEF in 1995 as a premier strategy to promote health and provide preventive and curative services for children.

At its inception IMCI focused on countries with more than 40 deaths per 1000 live births, and many African countries are in that bracket.

Graced by the Permanent Secretary of the Ministry of Health in Tanzania, who was represented by the Assistant Administrative Secretary of the Arusha Region, Mr. Abel Ntupwa, the meeting sought to share and discuss findings of IMCI stock-taking in the WHO African region, to rethink and recommend sustainable strategies for improving the quality of care for children at primary care levels and agree on a framework and strategic actionable next steps that should guide member states’ and partner investments in the medium term.

In his opening remarks, Dr. Zabulon Yoti, WHO Tanzania Country Representative said no sector can achieve child health and wellbeing alone. “The causes of child mortality go beyond the health sector. Poor sanitation, violence and injuries, poor education of caregivers require a more inclusive strategy that considers both health and wellbeing of a child. The children must survive and thrive,” said Dr. Yoti.

UNICEF remarks, given by Anne Detjen, a Child Health Specialist from UNICEF New York echoed multisectoral cooperation and emphasized the usefulness of community health care workers in promoting child health and wellbeing.

“We should focus on strengthening institutionalizing community health care and embrace community health care workers into the primary health care system by training and remunerating them. This will improve equitable access to primary health care that we all know plays a great role in reduction of child mortality,” said Anne Detjen.

Experts, analyzing child wellbeing in Africa note that the three main causes of child deaths in Africa 25 years ago are still devastating today. Pneumonia claims 13% of under five deaths, diarrhea accounts for 9% percent and malaria causes 10% of the deaths. All of them are preventable.

Through concerted political will, collaboration with development partners and expansive engagement of community, some countries in Africa have substantively addressed the impact of pneumonia, diarrhea and malaria on child health.

In Tanzania, where under 5 mortality rates has been suppressed from 147 to 43 now, the coverage of rotavirus vaccines has been maintained at above 90 percent for more than a decade.

“In the past we used to designate a ward in district hospitals for children suffering from common childhood illnesses such as diarrhea and measles. We no longer have designated wards to admit children with diarrhea,” said Dr Felix Bundala, the Acting Director of Child & Adolescent Health in Tanzania’s Ministry of Health.

Averting preventable deaths from the common causes of under 5 deaths, was the ideal of the WHO and UNICEF invention of IMCI 25 years ago. At its core, IMCI strategy promotes a holistic approach based on integration, equity, prioritization and standardized care for common illnesses, and acknowledgement of the limited capacity for clinical care in low income.

In 2000, multi country evaluation was conducted in Brazil, Peru, Bangladesh, Uganda and Tanzania and indicated that IMCI reduced child mortality by 13% in Tanzania and improved quality of care and rational use of medicines across many other countries.

In one of IMCI tales Tanzania innovated an IMCI distance learning program that cut costs of IMCI training by 70 percent from 1000 US dollars per learner to 300USD.

Several reviews by WHO, UNICEF, and partners including a 2016 global IMCI stocktaking showed that coverage remains very low, failing to attain the envisaged target of having 60% of sick children seen by IMCI trained health workers.

As time ticks toward 2030 for accountability on SDGs it is fair for anyone who cares about wellbeing of children to pause and investigate why is that despite the progress Africa countries have made in many economic and development fronts, still diarrhea, malaria and pneumonia are still killing children in our midst.

It is expected that the policy makers, resource persons and other stakeholders that have convened to rethinking IMCI in Arusha will develop solutions that will put African countries on track to attain its SGDs in reducing under 5 mortality.