Un gran proyecto para reducir drásticamente la mortalidad infantil

A Major Project Aimed at Dramatically Reducing Infant Mortality

16.6.2015

Less than 3% of the almost 7 million children under five years of age who die every year are seen before they die by a health care professionalMost deaths in the world occur in places where the civil registry system for recording births and deaths is either deficient or nonexistent. As a result, many people are born and die without any official record being made of their existence. Data on births and death is needed for many purposes and plays an essential role in informing national health policies. Moreover, the problem is compounded by the fact that these deaths occur in areas where it is difficult or almost impossible to establish cause of death. One statistic that dramatically illustrates the problem is that less than 3% of the almost 7 million children under five years of age who die every year are seen before they die by a health care professional who can medically certify the cause of death. Without solid information, determining the cause of these death involves questionable and imprecise assumptions. Experts are increasingly recognising that this lack of information on cause of death for the greater part of humanity is a key constraint for the establishment of effective health care interventions and programmes that could improve survival, particularly in the world’s most vulnerable populations.


Photo by Quique Bassat

The failure to achieve the MDG targets can be attributed to many factors, but one is undoubtedly the lack of data on the causes of deaths among women and childrenThe health of mothers and children is the subject of two of the Millennium Development Goals (MDG) established in 2000 with the target date of 2015. And it is precisely these two goals—particularly goal five relating to maternal health—that are furthest from achieving the targets set, mainly because the reduction in the number of deaths worldwide has been much slower than expected. Most of the deaths affecting mothers and children, above all newborn babies, occur in low-income countries, especially in sub-Saharan Africa. This failure to achieve the MDG targets can be attributed to many factors, but one is undoubtedly the lack of data on the causes of deaths among women and children, a shortcoming that hinders the implementation of effective action aimed at preventing such deaths in the future.

The Gates Foundation has accorded maximum priority in its agenda for the coming years to the determination of cause of death in children and has recently announced funding for a large project To help improve the data on cause of death in the world’s most impoverished populations and to increase survival in these areas, our team in the Barcelona Institute for Global Health (ISGlobal-Hospital Clínic/University of Barcelona) has been working on the problem for many years and is in the process of developing post-mortem diagnostic techniques that can be used by health care personnel without advanced training who work in rural areas of the countries where most of these deaths occur. The use of this minimally invasive autopsy technique is now being evaluated in collaboration with Maputo Central Hospital and the Manhiça Health Research Centre (CISM) in Mozambique and the Fundaçao de Medicina Tropical de Manaus in Brazil as part of a project funded by the Bill and Melinda Gates foundation. In recognition of the global importance of the issue, the Gates Foundation has accorded maximum priority in its agenda for the coming years to the determination of cause of death in children and has recently announced funding for a large project—the Child Health and Mortality Prevention Surveillance Network (CHAMPS)—in which the post-mortem diagnostic technique we are developing will be a key element.

The CHAMPS project, which is expected to last 20 years, will provide the accurate data that will make it possible to formulate more effective health policiesThe CHAMPS project, which is expected to last 20 years, will provide the accurate data that will make it possible to formulate more effective health policies, with the ultimate objective of achieving a dramatic reduction in child mortality. This ambitious programme is the result of a commitment to scientific research as a tool for change and—if the targets are achieved— it will serve as an example of the transformative capacity of scientific knowledge generated with the intention of translating it into action.