UNICEF’S Accelerated Child Survival and Development Program (ACSD) has been applied to selected focus districts in several West African countries. A retrospective analysis of the impact of this initiative in Benin, Ghana and Mali has just been published¹. The results are disappointing. Between 2001 and 2005 child (0-5yrs) mortality did decrease in the focus groups of all 3 countries, but in Benin and Mali, no significant advantage was conferred by the ACSD interventions when analysed against data from comparison groups. In Ghana comparison groups were not available. Improvements in expanded immunization coverage and in antenatal care were significant in response to the interventions but, unfortunately, care for children with malaria or pneumonia did not improve.

In a presentation to a May 2009 conference held in Canada entitled “Putting Science Into Action” Daniel Telfor Ph.D. provided a fascinating analysis of 2 American studies of early childhood intervention programs.¹

High quality programs of this nature are expensive, $15,000 per child, but he shows that the return on this investment (ROI) represents a net gain.

Compelling neurobiological and behavioural evidence points to events occurring between conception and 6 years of age as key determinants of human brain development. During these early years many external stimuli, sights, sounds, touch, food, effect the brain for life with lasting impacts on the child’s development, behaviour, school performance and vulnerability to various diseases. Coordinated science-based national clinical programs, in Sweden and Cuba for example, have shown that the deficiencies resulting from deficient shaping of a child’s development in those early years can be ameliorated or totally reversed. Unfortunately many wealthy countries, including Canada lag far behind in dealing with this major societal problem.

Thirty years ago, representatives of 134 WHO member states convened in Alma- Ata to discuss global health issues and the potential of primary health care to address huge needs. The Alma-Ata Declaration advocated the implementation of primary care health systems as a central strategy to achieve “Health for All by 2000” noting that an estimated 2 billion of the world’s people lacked access to health care at that time. This declaration met with significant resistance from various interest groups in 1978 but fortunately, its central strategy has gained momentum in recent years. The Lancet, in its September 13-16, 2008 issue, has revisited Alma-Ata with an editorial and extensive comments and articles.

A “Perspective,” published in the New England Journal of Medicine (359.8: 783-786, 2008), highlights the persisting, devastating global impact of preventable water-related diseases. Most of the 1.1 billion people who regularly lack access to sufficient, clean water live in low-income countries but recent natural disasters remind us that populations in any corner of the globe can be affected.

Who is working on these problems and where? If those working on producing sources of safe water and those involved in measuring its health impact post weblogs briefly describing their work, a productive dialogue might be generated on this website. If you are not directly involved in this field, spread the word to colleagues who are.

We hope to hear from you.

Richard Hamilton

The www.mother-child.org website has just undergone an extensive revision in an effort to provide a clear, concise image of our basic premises and purpose. We believe that these revisions will improve your access to the site’s facilities thereby helping you to achieve your objectives in research. So it’s a good time for us to question our own motives and methods in developing and promoting this website.

Specifically, we need your responses to the following questions:

GLOBAL HEALTH LEADERSHIP AWARDS: CALL FOR APPLICATIONS

Arsenic contamination of the drinking water used by millions of people in Asia and elsewhere in the Developing World presents a major potential public health crisis.

In developing countries where Western influence has promoted a lifestyle of little physical activity and high calorie foods, cases of obesity have tripled in the past 20 years.Hassan P et al.

A series of 3 papers on child development in developing countries indicate that developmental potential is being lost in more than 200 million children in low income countries1,2,3.