Childhood Pneumonia and Diarrhoea 3Bottlenecks, barriers, and solutions: results frommulticountry consultations focused on...
“Why are so many children stilldying of preventable conditions,and how do we move forward?”
Specific Objectives1. Identify key barriers to implementation of   programmes targeting pneumonia/diarrheoa2. Identify key...
Methods• A series of consultations with > 600 key stakeholders in 2010-12• 3 work streams provided data for 39 Asian & Afr...
Bottlenecks impeding access to                                vaccinesConcentrated upstream•Policy guidelines•Resources Le...
Bottlenecks impeding access to zinc and ORS      are concentrated ‘downstream’              zinc                 ORS
The Market Trap: Why zinc is so     expensive in Nigeria
Prioritization of the Barriers
Inadequate monitoring and assessment• Data not of high quality and not analyzed properly• Data often not shared with those...
Poor coordination of efforts•   Between programmes, across partners and sectors•   Duplication of efforts•   Failure to op...
Inadequate human resources•   Not enough health workers•   Low incentives for recruitment and retention•   Limited capacit...
Weak supply chain•   Over-reliance on central supply systems•   Supply not linked to need•   Inefficient stock/restock sys...
Quality of care• Evidence based standards of care not always available• Access to care limited• Low uptake due to poor qua...
This is a solvable problem:  The Bangladesh Story
The way forward
Conclusions• We can drastically reduce child  mortality with tools already at  hand   – Solutions are affordable and not  ...
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Bottlenecks, barriers, and solutions: Results from multicountry consultations focused on reduction of childhood pneumonia and diarrhoea deaths - Dr. Shamim A Qazi

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Dr. Shamim A Qazi: Bottlenecks, barriers, and solutions: Results from multicountry consultations focused on reduction of childhood pneumonia and diarrhoea deaths
World Health Organization
Geneva

As presented at Launch of The Lancet Series on Childhood Pneumonia and Diarrhoea, at the Royal College of Pediatrics and Child Health - 12 April 2013

In support of the UNICEF & WHO Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea

View the film accompanying the presentation at:

www.wateraid.org/news/news/global-action-plan-for-pneumonia-and-diarrhoea

Published in: Health & Medicine, Business
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Bottlenecks, barriers, and solutions: Results from multicountry consultations focused on reduction of childhood pneumonia and diarrhoea deaths - Dr. Shamim A Qazi

  1. 1. Childhood Pneumonia and Diarrhoea 3Bottlenecks, barriers, and solutions: results frommulticountry consultations focused on reduction ofchildhood pneumonia and diarrhoea deathsChristopher J Gill, Mark Young, Kate Schroder, Liliana Carvajal-Velez, MarionMcNabb, Samira Aboubaker, Shamim Qazi and Zulfiqar A Bhutta
  2. 2. “Why are so many children stilldying of preventable conditions,and how do we move forward?”
  3. 3. Specific Objectives1. Identify key barriers to implementation of programmes targeting pneumonia/diarrheoa2. Identify key bottlenecks impeding access to essential commodities – Diarrheoa: vaccines, zinc, ORS, – Pneumonia: vaccines, oral amoxicillin1. Propose solutions to those barriers
  4. 4. Methods• A series of consultations with > 600 key stakeholders in 2010-12• 3 work streams provided data for 39 Asian & African countries1. Global Action Plan for Pneumonia (GAPP) – Led by WHO/UNICEF – Broad focus on programmatic barriers/solutions1. Diarrheoa Global Action Plan (DGAP) – Led by Aga Khan University – Focus on programmatic barriers/solutions & 7 country case studies1. Diarrheoa and Pneumonia Working Group (DPWG) – Led by UNICEF and CHAI – Focus on supporting scale up treatment in high burden countries.
  5. 5. Bottlenecks impeding access to vaccinesConcentrated upstream•Policy guidelines•Resources Legend None Darker colorsconnote more significant bottlenecks Minor Moderate Major
  6. 6. Bottlenecks impeding access to zinc and ORS are concentrated ‘downstream’ zinc ORS
  7. 7. The Market Trap: Why zinc is so expensive in Nigeria
  8. 8. Prioritization of the Barriers
  9. 9. Inadequate monitoring and assessment• Data not of high quality and not analyzed properly• Data often not shared with those that need it most• Data not widely disseminatedResult: Programmes are unaware of their progressRecommendation: Improve the quality and establish mechanism for sharing and using data for action
  10. 10. Poor coordination of efforts• Between programmes, across partners and sectors• Duplication of efforts• Failure to optimize available resources• Conflicting prioritiesResult: Fragmented efforts dilute effectiveness & efficiencyRecommendation: Evidence based planning and management, joint development of plans and strategies for action
  11. 11. Inadequate human resources• Not enough health workers• Low incentives for recruitment and retention• Limited capacity building opportunities• Inadequate supervision and skills reinforcementResult: Chronic shortages of the skilled and motivated workersRecommendation: Explore and implement innovative ways for capacity building, motivation & supervision
  12. 12. Weak supply chain• Over-reliance on central supply systems• Supply not linked to need• Inefficient stock/restock systems• Limited local production of essential commoditiesResult: limited access to life saving commoditiesRecommendation: Strengthen systems for procurement and drug supply management and production of key commodities
  13. 13. Quality of care• Evidence based standards of care not always available• Access to care limited• Low uptake due to poor qualityResult: Children die of preventable and treatable conditionsRecommendation: Client feedback as part of health worker and clinic assessment; dissemination of guidelines
  14. 14. This is a solvable problem: The Bangladesh Story
  15. 15. The way forward
  16. 16. Conclusions• We can drastically reduce child mortality with tools already at hand – Solutions are affordable and not high tech• The ingredients of success start with – Coordinated action plan – Resources commensurate with the burden of disease – Accountability for results – Advocacy

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