This post was written by Monica Zaccarelli Davoli in collaboration with UNICEF colleagues
Routine access to health services remains challenging in many rural communities. Until the routine health system capacity is sufficiently increased, National Health Weeks (NHWs) play an important short to medium term role in delivering a core set of basic maternal and child health services through Government systems at a national level. In 2011, more than 3 million children were reached through these campaigns. As a result, coverage rates for vitamin A supplementation and measles vaccination were estimated to be 80% (unpublished UNICEF survey data), compared to 65 per cent for vitamin A supplementation before the introduction of NHWs.
Preparing a meal ©UNICEF Mozambique
Last week, UNICEF Executive Director Tony Lake wrote a brief, yet powerful Op-Ed on the less known type of malnutrition called “stunting”. Stunting is the irreversible outcome of chronic nutritional deficiency during the first 1,000 days of a child’s life, i.e. from conception up to their second birthday. Stunted children look like “normal” children, but they are shorter than children of the same age. They are five times more likely to die from diarrhoea; and their brain development is impaired: the neurons of a stunted child are in fact fewer and smaller. The physical and cognitive damage caused by not receiving enough of the right type of nutrients in the first 1,000 days of life is permanent. It cannot be treated. But it can be prevented in these first 1,000 days– and at relatively little cost. A cost that is far below the economic and social benefits of its prevention.
Baby with Cartao de Saude da Crianca ©UNICEF Mozambique
In May 2011 the Ministry of Health run a nationwide measles campaign as part of the Child Health Week targeting 3.6 million children aged 6-59 months. The campaign was adequately financed and well organized, with thousands of teams on the ground distributing the vaccine, along with vitamin A and mebendazole for deworming. The administrative results of the 5-days long campaign went beyond expectations: the campaign apparently reached 3.9 million children, i.e the totality of the target group plus a considerable amount of extra children outside the age group. The total administrative coverage was 104%.
In September, the results of a measles coverage survey conducted after the campaign were released by Ernst & Young. The survey showed a coverage of only 80%, much lower than the administrative coverage. So, which source should be trusted? And ultimately, was the campaign a success (as administrative data suggest), or a failure (as coverage data suggest)?