title: Examining the evidence of under-five mortality reduction in a community-based programme in Gaza, Mozambique.
abstract: 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.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
authors.forename: Anbrasi
authors.initials: A
authors.lastname: Edward
authors.forename: Pieter
authors.initials: P
authors.lastname: Ernst
authors.forename: Carl
authors.initials: C
authors.lastname: Taylor
authors.forename: Stan
authors.initials: S
authors.lastname: Becker
authors.forename: Elisio
authors.initials: E
authors.lastname: Mazive
authors.forename: Henry
authors.initials: H
authors.lastname: Perry
mesh_terms: D002648:Child; D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D003153:Community Health Services / Q000706:statistics & numerical data; D019058:Community Networks; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D008297:Male; D009073:Mozambique / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology