Pneumonia, diarrhea deaths still high among vulnerable children
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* Julia Haskins

Countries with high burdens of child pneumonia and diarrhea deaths must do more to meet goals toward preventing such deaths, a new report finds.

Released ahead of World Pneumonia Day on Nov. 12, the “2018 Pneumonia and Diarrhea Progress Report” examined progress toward the World Health Organization and UNICEF’s targets to slash deaths from pneumonia and diarrhea among children by 2025. Of the 5.7 million children who died before their fifth birthday in 2016, nearly one-quarter died from pneumonia or diarrhea, according to the report from the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health.

WHO and UNICEF’s Global Action Plan for Pneumonia and Diarrhea outlines interventions focused on protection, prevention and treatment. Under protection, the plan calls for 50 percent of children to be exclusively breastfed within the first six months of life. Prevention aims for 90 percent coverage of vaccinations, while treatment goals seek 90 percent coverage for children with suspected pneumonia and diarrhea. As the latest progress report found, countries with the highest burdens of child pneumonia and diarrhea deaths are falling short of the targets.

None of the 15 high-burden countries examined in the report met the global action plan’s target score of 86 percent across 10 interventions, and eight countries did not meet any intervention targets. Among the countries, all of which were in Africa or Asia, Tanzania received the highest average score and Somalia received the lowest. All 15 countries also scored the same or higher on targets to prevent and treat pneumonia than diarrhea. According to the report, low diarrhea indicator scores are largely attributed to low zinc coverage among children with diarrhea.

In a first for the annual report, data were evaluated based on gender, wealth, maternal education and residence to determine inequities as they related to four indicators: pneumonia care-seeking, oral rehydration solution, zinc supplementation and exclusive breastfeeding. The findings pointed to some inequities based on geography and wealth. For example, rates of pneumonia care-seeking were higher in urban versus rural areas for six of 11 countries with available data. In addition, coverage was at least 10 percentage points higher among the wealthiest quintiles compared with the poorest quintiles in six out of nine countries with available data.

The report provided several recommendations to prevent and treat child pneumonia and diarrhea. Among the recommendations was a call to bolster data collection and reporting, with data that include key equity indicators. It also recommended developing and scaling up interventions related to disparities in access to protection, prevention and treatment as well as focusing on underserved communities and populations. In addition, the report called for continued funding and a comprehensive, integrated strategy to address health equity.

“It is our hope that policymakers and public health officials in these countries use this information to improve access to health services for their children, even the hardest to reach,” said Kate O’Brien, MD, MPH, executive director of the International Vaccine Access Center, in the report. “Only with equitable access to — and delivery of — comprehensive pneumonia and diarrhea prevention and control programs will we stand a chance of ending preventable child deaths.”

For more information and to access the report, visit [bit.ly/pneumonia-progress](http://bit.ly/pneumonia-progress).

*   Copyright The Nation’s Health, American Public Health Association