Intended for healthcare professionals


Going the last mile in child survival in India

BMJ 2014; 349 doi: (Published 29 August 2014) Cite this as: BMJ 2014;349:g5222
  1. Anita Jain, India editor, The BMJ
  1. 1Mumbai, India
  1. Correspondence to: ajain{at}

It helps to have the right care, at the right time, from the right providers

The language of global public health seems to be punctuated by “gaps,” perhaps most starkly on the frontier of child survival where, despite concerted efforts, nearly 18 000 children under the age of 5 years continue to die every day. A large majority of these succumb to conditions such as pneumonia and diarrhoea, against a backdrop of pervasive undernutrition.1 More than half of them fail to receive appropriate and timely medical care.2 The knowledge and technologies to prevent or treat these conditions have long been established. However, taking these the last mile to improve health outcomes remains a challenge. A priority setting exercise by the World Health Organization accorded prime importance to research investigating the optimal use of known interventions for child health and the barriers to efficient delivery.3

The Integrated Management of Childhood Illnesses initiative launched in the early 1990s aims to foster early recognition of childhood illnesses by the family, enhanced linkages between communities and health facilities, and prompt and appropriate treatment delivered through strengthened …

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