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Analysis Strategic Review of Child Health

Child health guidelines in the era of sustainable development goals

BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3151 (Published 30 July 2018) Cite this as: BMJ 2018;362:bmj.k3151

Strategic review of child health

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  1. Jonathon L Simon, scientist1,
  2. Bernadette Daelmans, WHO coordinator1,
  3. Cynthia Boschi-Pinto, WHO medical officer1,
  4. Samira Aboubaker, WHO medical officer1,
  5. Wilson Were, WHO medical officer1
  1. 1World Health Organization, Geneva, Switzerland
  1. Correspondence to: J L Simon simonjo{at}who.int

Child health guidelines must broaden in scope beyond under 5 mortality to facilitate improvements in child health and development necessary to meet the 2030 sustainable development goals, say Jonathon L Simon and colleagues

As the United Nations coordinating authority for international health, the World Health Organization has a vital role in producing scientifically valid and up to date global guidance. It is a challenge to keep the guidelines relevant and evidence based amid changing demography and disease epidemiology and expansion of scientific information and new priorities.

The Integrated Management of Childhood Illness (IMCI) strategy was launched in 1995. It aimed to collate technical guidance related to management of the leading causes of childhood mortality in a holistic and child centred way. These guidelines were developed through review of evidence and based on expert consensus recommendations. Since 2007, a systematic review of evidence has been followed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach, managed by an independent guideline review committee.1

Since the IMCI strategy was launched most countries have made substantial progress in reducing mortality among children under 5 years old. Overall, global mortality among under 5s has declined by an estimated 56% since 1990.2 During this period, the global child health environment has changed markedly with the advent of sustainable development goals and epidemiological and demographic transitions. WHO is undertaking a comprehensive review of the child health guidelines to make them more appropriate for the needs of different countries and situations.3

Here, we discuss the changes needed based on the changing epidemiology and the analytical background papers and recommendations from the 2016 strategic review of IMCI and the results of the IMCI global implementation survey.4 In addition, we draw on the strategic direction provided by the Global Strategy for Women’s, Children’s and …

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