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Africa: Using Health Scorecard to Monitor Child Mortality Rates

Mothers from southern Somalia hold their children at medical center in Mogadishu, Somalia, August 3, 2011.
Mothers from southern Somalia hold their children at medical center in Mogadishu, Somalia, August 3, 2011.
African governments will implement a health scorecard to reduce child deaths on the continent. Delegates attending the African Child Survival Conference also set higher targets to bring down the child mortality rate.
 
The health scorecard is a monitoring system that publicly collects and reports health data and it has produced good results in several African countries such as Ethiopia. Delegates adopted the scorecard to reduce child deaths as they gathered at the African Union headquarters for the African Child Survival Conference. They also set a new target date by which child deaths should be reduced.
 
Peter Salama is the United Nations Children's Fund (UNICEF) representative to Ethiopia. He is impressed by the new commitments made by African governments especially the commitment to the scorecard:
 
“They’ve agreed to bring down child mortality to 20 per 1000 live births.  What that means is these poor countries have agreed to bring child mortality down to the levels of an upper middle-income country, right across the continent. They committed to make sure this is not just an empty promise, and that’s really through this initiative of strengthening robust monitoring systems, one of which will be this national scorecard," Salama said.

The scorecard consists of three parts:   information on policy issues and availibility of resources, information on the process of treatment and information on the results of treatment.
 
Efforts to reduce child mortality are urgently needed in sub-Saharan Africa as 1 in 8 children dies before the age of five. One of the goals of the United Nations millennium development project is to bring down the mortality rate by two-thirds by 2015. Many African countries are not on track yet to reach these goals as reduction is currently at 39 perecent.
 
Ethiopian Minister of Health Kesetebirhan Admasu hopes the new commitments will contribute to health policies in the long run. “Beyond 2015 we should consider and develop new strategies to ensure the inclusion of more innovative and proven interventions in equitable manner for children survival,” Admasu stated.
 
The Democratic Republic of Congo (DRC) is one of the African countries that has not been able to improve its rates due to the conflict situation in the country. Still today, 158 out of 1,000 children die in Congo during birth. DRC Health Minister Felix Kabange Numbi says the scorecard can reduce that rate:
 
“In Congo we are doing monitoring and we have a plan of evaluation and follow up but we don’t have a scorecard and I was very happy to see how Ethiopia presents its scorecard with each province and each indicator. Its why we say in DRC, from here to the end of March we must have our scorecard and to follow up how we can go forward,” Numbi noted.
 
The scorecard provides better data on what sort of policies are needed to eliminate preventable child deaths.

Peter Salama of UNICEF says the it can therefore be used all over the continent as it gives an insight on what causes children to die. “Making sure that you tailor your programs and interventions very much according to that evidence base. There is a large number of these interventions so you have to choose the package for your child mortality pattern in your country, and all of the countries are now working on these plans to refine them to make sure they choose exactly the right high impact interventions that are most cost effective.”
 
Even countries that have improved their rates when it comes to preventable child diseases, such as Namibia, are positive about introducing the scorecard. But Namibian Minister of Health Richard Nchabi Kamwi says regional integrated health approaches are just as important to fight other diseases that kill children such as malaria:
 
“The next step is to engage other colleagues because there is no way that we alone can make it work. We can only work when we stand working together as a team,” said Kamwi.
 
United Nations officials say the most effective and efficient interventions for preventing child deaths are by tackling malaria, pneumonia, diarrhea and neonatal mortality. The hope is to have ended all preventable deaths among children by 2035.

Liberia is currently the best scoring African country by reducing its under five-mortality rate by 67percent.

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