By George Fominyen
DAKAR (AlertNet) - A UNICEF programme aimed at reducing child mortality by at least 25 percent in West Africa has failed to meet its objective, according to a study published in The Lancet medical journal this week.
The $27 million Accelerated Child Survival and Development Programme (ACSD) was implemented in selected districts of 11 countries between 2001 and 2005.
However, researchers concluded that mortality in children under five fell by 13 percent in Benin, 24 percent in Mali and 20 percent in Ghana, but that the decreases in Benin and Mali were no greater than in areas which were not part of the
project. Comparison data was unavailable for Ghana.
"We think it is partly because UNICEF and the partners were doing the same thing in other parts of the countries and also because UNICEF did not implement some of the highest impact interventions to address the major causes of child death," Jennifer Bryce, one of the authors of the report, told AlertNet in a phone interview.
Little intervention to address undernutrition and stock shortages of insecticide-treated nets restricted the potential effect of this programme, the UNICEF-commissioned evaluation
found.
It also said that the most well-designed programmes would always falter if drugs were not available or the drug supply was interrupted -- pointing out that artemisinin-based combination
therapies for malaria were not available in Benin or Mali until 2007.
The report also said the community component of the programme was weak with workers receiving no remuneration for their work and little supervision.
"What they did was good but they should have done more. We must do more, it was not enough," Bryce said.
Bryce said national health ministries need to use their resources to address the major causes of death, while donors need to provide more funding and allow national governments to spend it on interventions that prevent the most deaths.
UNICEF however said there had been progress in tackling child mortality in most countries in the region.
"For instance, Ghana before the programme had a flat and stagnant mortality rate and since 2003 there is significant drop in under-five mortality in Ghana -- a 31 percent drop which is a
really honourable drop," Barbara Bentein, the deputy regional director for UNICEF in West and Central Africa, told AlertNet in Dakar.
"We know what works. We know what the effective
interventions are. We just have to make sure that the health systems and partnerships really work for children," Bentein said.
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