title: Bottlenecks, barriers, and solutions: results from multicountry consultations focused on reduction of childhood pneumonia and diarrhoea deaths.
abstract: Millions of children still die unnecessarily from pneumonia and diarrhoea, mainly in resource-poor settings. A series of collaborative consultations and workshops involving several hundred academic, public health, governmental and private sector stakeholders were convened to identify the key barriers to progress and to issue recommendations. Bottlenecks impairing access to commodities included antiquated supply management systems, insufficient funding for drugs, inadequate knowledge about interventions by clients and providers, health worker shortages, poor support for training or retention of health workers, and a failure to convert national policies into action plans. Key programmatic barriers included an absence of effective programme coordination between and within partner organisations, scarce financial resources, inadequate training and support for health workers, sporadic availability of key commodities, and suboptimal programme management. However, these problems are solvable. Advocacy could help to mobilise needed resources, raise awareness, and prioritise childhood pneumonia and diarrhoea deaths in the coming decade.
authors.affiliation: Boston University School of Public Health, Boston, MA, USA. cgill@bu.edu
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Gill
authors.forename: Mark
authors.initials: M
authors.lastname: Young
authors.forename: Kate
authors.initials: K
authors.lastname: Schroder
authors.forename: Liliana
authors.initials: L
authors.lastname: Carvajal-Velez
authors.forename: Marion
authors.initials: M
authors.lastname: McNabb
authors.forename: Samira
authors.initials: S
authors.lastname: Aboubaker
authors.forename: Shamim
authors.initials: S
authors.lastname: Qazi
authors.forename: Zulfiqar A
authors.initials: ZA
authors.lastname: Bhutta
mesh_terms: D046688:Child Mortality; D002669:Child Welfare; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003906:Developing Countries; D003967:Diarrhea / Q000401:mortality*; D014943:Global Health; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007391:International Cooperation; D011014:Pneumonia / Q000401:mortality*