Examining the evidence of under-five mortality reduction in a community-based programme in Gaza, Mozambique

Trans R Soc Trop Med Hyg. 2007 Aug;101(8):814-22. doi: 10.1016/j.trstmh.2007.02.025. Epub 2007 May 4.

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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Child
  • Child Mortality / trends*
  • Child, Preschool
  • Community Health Services / statistics & numerical data
  • Community Networks
  • Female
  • Humans
  • Infant
  • Infant Mortality / trends*
  • Infant, Newborn
  • Male
  • Mozambique / epidemiology
  • Patient Acceptance of Health Care
  • Pregnancy
  • Pregnancy Complications / epidemiology