Child Survival

JSI designs and implements projects and activities to advance the health, development, and well-being of children worldwide. As part of these efforts, JSI chronicles—along with its partners in the BASICS project as well as in other programs—its research and progress in order to inform others about the issues behind child mortality and shares evidence-based solutions to these critical issues.

For JSI-authored articles in peer-reviewed journals please go to Journal Articles.

Please note the following are listed in chronological order starting with the most recent publication.

General | Immunization | C-IMCI| Perinatal and Neonatal Health

GENERAL

Protecting Ourselves and Each Other: A Child Rights and Protection Resource (PDF, 2.65 MB)

This booklet was developed in Western Uganda to raise awareness among children and caregivers about child protection and child rights issues. The guide contains information that helps children and their friends understand their rights and responsibilities and find ways to identify resources in their communities that can help when rights are being violated. The booklet is also useful for teachers, caregivers, and other organizations working to strengthen community child protection services.

Developed by the Bantwana Initiative and Francois-Xavier Bagnoud-Uganda in conjunction with worked community-based organizations, youth-led child rights clubs, and district officials in the districts of Kasese, Kabarole, and Kyenjojo in Western Uganda. Bantwana Initiative and Francois-Xavier Bagnoud-Uganda, 2010.

Trend in Reproductive, Maternal, Neonatal and Child Health Indicators, The Ethiopia Last Ten Kilometers Project Areas, Southern Nations, Nationalities and People's Region 2005-2009 (PDF, 1.07 MB)

The report analyzes the trend in the reproductive, maternal, neonatal, and child health (RMNCH) care seeking behaviors and practices in 30 L10K Project woredas of the SNNP region of Ethiopia to assess the impact of the health extension program (HEP). For the report, data from the L10K baseline survey conducted between December 2008 and January 2009 and the 2005 Ethiopian Demographic and Health Survey is used. The study indicates that the HEP has demonstrated significant achievements in latrine construction and use, distribution of insecticide treated bed nets (ITNs), use of family planning, antenatal care services, and immunization coverage; however, the program is lagging behind in certain areas including the provisions for safe and clean delivery, postnatal and neonatal care services. The HEP needs to improve maternal and neonatal health service delivery strategies. JSI/Ethiopia L10K Project. 2009.

Ethiopia L10K Baseline Household Health Survey Summary Report (PDF, 539 KB)

The Ethiopia Last Ten Kilometers (L10K) Project in collaboration with the Regional Health Bureaus of Amhara, Oromiya, SNNP and Tigray conducted a baseline household health and community survey to benchmark the reproductive, maternal, neonatal and child health (RMNCH) outcome indicators in its project areas. The survey which was conducted during the period December 2008 - January 2009 gathered information from 204 communities or kebeles and 6,277 women using a two-stage cluster sampling methodology. This report presents the survey results that describe the availability, perceived quality, awareness, knowledge, demand, access and utilization of RMNCH services in the L10K project areas. This report is the first-of-its-kind to describe the neonatal health care practices in rural Ethiopia. Implications of the survey findings for the health extension program of the Ethiopian Government are discussed. JSI/Ethiopia L10K. 2009.

Egypt: Control of Diarrheal Diseases Goes National (PDF, 343 KB)

This case study, developed as part of JSI's Best Practices in Scaling Up series, describes the national implementation of JSI's oral rehydration therapy (ORT) program to treat diarrheal disease in Egypt. Prior to this intervention, dehydration due to diarrhea was the leading cause of death in Egyptian children under five-years-old; meanwhile, ORT was emerging as a simple and sustainable option that could help reverse this trend. The case study delineates the course of this mass life-saving effort in the 1980s and 1990s, including steps in scale-up, the role of media in bringing about behavior change, and results of the efforts. As a result, virtually all mothers in Egypt understand and practice the preparation and use of ORT, and diarrheal disease control is now integrated into the Ministry of Health's activities. Susan Klein and Elizabeth Burleigh, John Snow, Inc., 2008.

Community Mental Health Treatment, Protection and Promotion for Women and Children in Aceh: Findings From an Evaluation of Programs Supported By The Health Services Program (PDF, 390 KB)

This report presents results from the successful Indonesia Health Services Program (HSP) Mental Health and Psychosocial initiative that took place following the devastating earthquake and tsunami in December 2004. In response to this disaster, HSP began work in Aceh to address the psychosocial and protection needs of women and children.

Key findings include the development of a household-to-hospital continuum of mental health care and a mental health system that has assisted with the restoration of health, human rights and human dignity. Survey findings concerning the new mental health program concluded that 90% of patients and caretakers reported improvements in mental health or social functioning. Developed by JSI Research & Training Institute, Inc. in conjunction with Columbia University Mailman School of Public Health and support from the USAID funded HSP Project. JSI Research & Training Institute, 2007.

Acute Respiratory Infection Pamphlet (PDF, 388 KB)

This pamphlet was designed to support appropriate and rational care of children with acute respiratory infections. Guidelines are intended to help parents identify and manage respiratory illness and know when to seek medical attention; guidelines also offer advice for treatment. John Snow, Inc., 2007.

Newborn Hypothermia Pamphlet (PDF, 569 KB)

A newborn baby cannot generate, maintain, or regulate body temperature as well as an adult, especially if the baby is underweight or premature. This pamphlet emphasizes the importance of keeping a newborn warm after birth and details steps in the warm chain to do so. This information is targeted at new mothers, their families, and providers, with emphasis on colder climates, such as Central Asia. John Snow, Inc./ZdravPlus Project. 2007.

Health Services Program 2006 Annual Report (PDF, 2.73 MB)

The USAID-funded Health Services Project in Indonesia is implementing maternal, newborn and child health interventions at the district level, including the hard-hit Aceh district, and is working with health facilities, NGOs and community organizations as well as the private commercial sector. This report reviews the accomplishments of the project's first year. JSI Research & Training Institute, Inc, 2006.

Healthy Mother/Healthy Child Project Completion Report (DOC, 31.05 MB)

This final report presents the results from the successful Egypt Healthy Mother/Healthy Child (HM/HC) project. In conjunction with the Egypt Ministry of Health, over the life of twelve-year project, HM/HC helped reduce maternal mortality by 52% and infant mortality declined by almost 20%. Through both upgraded and new maternal and child healthcare facilities, more than 22 million people have improved access to essential services. Both a summary and detailed analysis of the key project achievements can be found in the HM/HC Completion Report. 2005.

Nepal Child Survival Case Study: Technical Report (PDF, 2.47 MB)

Nepal has a long history of successful child survival and reproductive health programs that were implemented at scale and at the community level. These programs are credited with accelerating the declines in infant and child mortality in recent years. This case study reviews the processes and events that influenced expansion of the programs and achievement of results in several technical areas, including pneumonia treatment, vitamin A supplementation, immunization, and family planning. This report provides an overview of the context and evolution of programs; trends in mortality and malnutrition in Nepal; a description of intervention programs; a discussion of cross-cutting components such as the use of female community health volunteers, behavior change communications, information systems, and logistics and supplies; and lessons learned. John Snow, Inc./BASICS II. 2004.

The CAPA Handbook: A 'How-To' Guide for Implementing Catchment Area Planning and Action, a Community-Based Child Survival Approach (PDF, 1.06 MB)

This manual provides step-by-step guidelines for implementing the CAPA approach and was developed for use by State Ministries of Health, program managers, technical staff, and donor agencies involved in community-oriented approaches for child survival activities. Basic Support for Institutionalizing Child Survival/Nigeria (BASICS II/N), in collaboration with Nigeria's federal and state governments, conceptualized and designed a community-based approach called Catchment Area Planning and Action (CAPA) to empower community members to take an active role in improving the health of their children, specifically around immunization, nutrition, and malaria. CAPA's approach places the locus of health program development at the community level with the intent of creating community ownership, promoting public and private sector partnerships, and stimulating demand. The approach is flexible enough for adoption by other development ministries and partners in Nigeria or by other developing countries, and its adaptation and its use in other sectors and contexts are encouraged. John Snow, Inc./BASICS II. 2004.

Rapid Assessment of Referral Care Systems: A Guide for Program Managers (PDF, 3.23 MB)

This tool is designed to help national and district-level managers quickly assess the status of and constraints to referring severely ill children from the first-level of care to secondary and tertiary levels of care. The assessment uses a cross-sectional study design that includes a review of medical records, interviews with caretakers of children less than five years of age, interviews with health providers, and focus group discussions with caretakers. Prevalence estimates describe referral care patterns of caretakers and providers, referral and counter-referral relationships, frequency of self-referral to higher levels of care, caretaker barriers to compliance with referral, and provider barriers to compliance with referral guidelines. Assessment results are for use by Ministries of Health and other partners to design national- and district-level interventions to improve the successful referral of severely ill children. John Snow, Inc./BASICS II. 2003.

Nepal Case Study Program Evolution and Lessons Learned: Annotated Bibliography of Reports and Materials on Child Survival Programs (PDF, 409 KB)

This document is an annotated bibliography of reports and materials on child survival programs. It was developed as part of Nepal Child Survival Case Study: Technical Report. Published by the Basic Support for Institutionalizing Child Survival Project (BASICS II) for the United States Agency for International Development. John Snow, Inc./BASICS II. 2003.

Tools for Operationalizing Essential Nutrition Actions (PDF, 222 KB)

Annotated bibliography of tools for operationalizing essential nutritional actions. JSI/BASICS II. 2003.

Immunization

The GAVI Alliance Civil Society Organizations Type B Case Studies: Afghanistan, the Democratic Republic of the Congo, Ethiopia and Pakistan (PDF, 1.29 MB)

Global Alliance for Vaccines and Immunizations (GAVI Alliance) support helps strengthen the coordination and representation of civil society organizations in national-level coordination mechanisms. This paper documents best practices and lessons learned from CSO and government collaboration in the Democratic Republic of the Congo, Ethiopia, the Islamic Republic of Afghanistan and Pakistan. In particular, this paper highlights processes and practices supported with GAVI CSO Type B funding related to hard-to-reach populations, technical assistance and capacity building and social mobilization and advocacy. The information was collected in November 2009. Wendy Abramson. March 2010.

Routine Immunization Checklist (PDF, 63 KB)

This document lists 12 indicators to help district- and national-level staff strengthen the performance of their routine immunization programs. JSI/IMMUNIZATIONbasics, 2005.

Strengthening Immunization Programs: The Communication Component (PDF, 1.43 MB)

This report provides an overview of immunization communication and describes how to maximize its contribution to immunization programs in developing countries. The discussion and examples focus on communication's place within immunization planning, activities, and partnerships, based on lessons learned from behavior-centered analyses and programming. A detailed case study of Madagascar's immunization communication activities is provided as an example of country implementation. John Snow, Inc.,/BASICS II. 2004.

Increasing Immunisation Coverage in Uganda: The Community Problem Solving and Strategy Development Approach (PDF, 238 KB)

During the past decade, immunization coverage in Uganda has been as low as 30% in some districts. Poor social mobilization and insufficient community participation are two of the reasons identified as major contributing factors for poor coverage.

To address these challenges, the UNEPI (Uganda National Expanded Program on Immunization) Policy and Revitalization Plan of the National Health Policy and Health Sector Strategic Plan calls for community involvement in health and linkages between health workers and the community. JSI/BASICS. 2003.

Immunization Essentials: A Practical Field Guide (PDF, 3.54 MB)

This manual has been written for immunization program managers at national and sub-national levels in developing countries and for people who support these managers, particularly field staff of donor agencies. Our intention is to provide information that is practical as well as technically and operationally sound. For readers who would like to explore topics in greater depth, we have provided additional
references.

Download French (PDF, 5.18 MB)

Download Spanish (PDF, 8.77 MB)

The Immunization Inter-Agency Coordination Committee Model - Example from DR Congo (PDF, 346 KB)

Inter-agency Coordinating Committees (ICCs) have been formed in countries to improve coordination among partners in support of immunization programs and control of vaccine-preventable diseases. Following the political & economic crises in the early 1990s in the Democratic Republic of Congo (DRC), UN agencies, embassies, & NGOs began organizing themselves to address health epidemics and diseases in the country. This umbrella committee served to mobilize resources and coordinate partners, with initial focus on the Ebola epidemic in Kikwit in 1995. This case study documents key elements & process for effective ICC collaboration and implementation of effective activities and plans. BASICS II/John Snow, Inc., 2002.

Communication Handbook for Polio Eradication and Routine EPI (PDF, 1.32 MB)

This Handbook is designed to help you, the programme officer, design and implement effective, research-driven communication programmes to meet present and future needs of your EPI programme. Although it emphasizes EPI, the content of the Handbook can be applied to other health communication interventions as well. BASICS/John Snow, Inc., 2000.

The Polio Eradication Initiative: Monitoring Service Delivery During National Immunization Days and Assessing the Local Capacity to Strengthen Disease Surveillance (PDF, 301 KB)

This report on polio eradication encourages effective monitoring and accurate disease surveillance to improve the quality of health services and disease control and eradication initiatives. The information and tools in the report evolved from actual use during National Immunization Days (NIDs) and from field assessments in several African countries. While most of the materials were developed for polio eradication, the concepts and tools also apply to routine health services. National and district Ministry of Health program managers can use the report as a reference guide to monitor and supervise their country programs. For field staff and managers, the report is a valuable reference tool for planning country activities. BASICS II/John Snow, Inc., 1998.

Community Integrated Management of Childhood Illness (C-IMCI)

Community Case Management Essentials Guide: Treating Common Childhood Illnesses in the Community: A Guide for Program Managers (PDF, 3.95 MB)

While the leading causes of death among children under five are well understood - efforts to protect the children most at risk have not kept pace with global goals. But now a growing body of evidence supports a new approach that may make a dent in childhood deaths from the biggest killers: pneumonia, diarrhea, malaria, newborn infection and malnutrition. This publication provides operational guidance to design, plan, implement, monitor, and/or advocate for community case management (CCM) of childhood illnesses that responds to local needs. It is a how-to guide for programs, rather than a source of clinical guidance. Designed primarily for program managers at the district level - from ministries of health and NGOs - central-level planners, advocates, academics, and other international health professionals will also find this guide useful. The guide was funded by USAID through the CORE Group, Save the Children, BASICS, and MCHIP. 2010.

A Guide to Conducting Mortality Surveys and Surveillance (PDF, 3.48 MB)

The Mortality (Pathway) Survey Manual describes a methodology for capturing quantitative and qualitative data on care giving and care seeking during a catastrophic illness (death). The methodology is based on a conceptual model for care seeking called the Pathway to Survival. The Pathway delineates all the steps that may occur during a child's illness, the decisions made, the different actors involved, the care provided at home and in facilities, and whether providers and care takers complied with recommendations and standards. By evaluating each of the steps in the Pathway, the methodology can clarify the public health importance of different interventions and health sector investments.

The Manual contains guidelines and all of the materials a survey planner will need for implementing a mortality (pathway) survey. From questionnaires, to how to do the sampling or set up a mortality surveillance, the manual contains materials and step-by-step instructions for doing the survey at national and district levels. BASICS II/John Snow, Inc., 2007.

Technical Bases for Integrated Management of Childhood Illness (PDF, 987 KB)

BASICS II powerpoint slides

Perinatal and Neonatal Health

Community-Based Management of Neonatal Infections in Nepal: Establishing a Model in One District - Final Report (PDF, 4.56 MB)

This final report of the Morang Innovative Neonatal Intervention (MINI) project Nepal. This final report of the contains information regarding the process of MINI project and includes the purpose of the project, its goal and objectives, method of training, implementation, data collection, supervision, evaluation and monitoring. This report also highlights the major outcome of the project. This report is useful for the organizations and community health program officers working or developing community-based management of neonatal infections.

The MINI project and this publication was made possible with financial support from the Saving Newborn Lives program of Save the Children/USA with funds from Bill & Melinda Gates Foundation. JSI Research & Training Institute, Inc./Morang Innovative Neonatal Intervention (MINI) project Nepal. 2009.

Community-Based Management of Neonatal Infections in Nepal: Establishing a Model in One District- MINI II (PDF, 369 KB)

This four-page technical brief provides an overview of the Morang Innovative Neonatal Intervention (MINI) project's work in Nepal. It contains background, objectives, MINI activities, results and lessons learned by the project. which was developed to address the persistent high neonatal mortality in that country. MINI was designed as a community-based learning project looking at scaling-up management of neonatal infections and was implemented in throughout the 65 Village Development Committees of the Morang District of Nepal. This document is useful for organizations, public health workers and people working in community-based management of neonatal infections.

The MINI project and this publication was made possible with financial support from the Saving Newborn Lives program of Save the Children/USA with funds from Bill & Melinda Gates Foundation. JSI Research & Training Institute, Inc./Morang Innovative Neonatal Intervention (MINI) project Nepal. 2009.

Female Community Health Volunteer's Training Facilitator Guide (PDF, 1.22 MB)

This Female Community Health Volunteers (FCHVs) training facilitator manual was developed to guide trainers who are facilitating training on community-based management of neonatal infection. This facilitator guide can be used by trainers who are providing community-based training on neonatal sepsis management.

JSI Research & Training Institute, Inc. was provided financial support for the development and the production of this material by Saving Newborn Lives program of Save the Children/USA with funds from Bill and Melinda Gates Foundation. JSI/Morang Innovative Neonatal Intervention (MINI) Project, Nepal. 2009.

Health Facility Staff/Village Health Workers/ Maternal and Child Health Worker's Training Facilitator Guide (PDF, 1.22 MB)

This Health Facility Staff (HF)/ Village Health Workers (VHWs)/ Maternal and Child Health Workers (MCHWs) training facilitator guide was developed to guide trainers who are facilitating training on community-based management of neonatal infection to the most peripheral government health workers who are immediate supervisors to community health workers. This facilitator guide can be used by trainers who are providing community-based training on neonatal sepsis management.

The MINI project and this publication was made possible with financial support from the Saving Newborn Lives program of Save the Children/USA with funds from Bill & Melinda Gates Foundation. JSI Research & Training Institute, Inc./Morang Innovative Neonatal Intervention (MINI) project Nepal. 2009.

Training Manual for Female Community Health Volunteers (FCHVs) (PDF, 4.47 MB)

This training manual for Female Community Health Volunteers (FCHVs) was developed to train FCHVs on community-based management of neonatal infections. This manual was developed considering the semi-literate/ illiterate status of the FCHVs. This manual can be used to train community health workers and volunteers on neonatal sepsis management.

The MINI project and this publication was made possible with financial support from the Saving Newborn Lives program of Save the Children/USA with funds from Bill & Melinda Gates Foundation. JSI Research & Training Institute, Inc./Morang Innovative Neonatal Intervention (MINI) project Nepal. 2009.

Training Manual for Village Health Workers and Maternal and Child Health Workers (PDF, 4.60 MB)

This training manual for Village Health Workers (VHW)/ Maternal and Child Health
Workers (MCHWs) was developed to train the most peripheral government health workers on community-based management of neonatal infections. VHW/MCHWs are the immediate supervisors for Female Community Health Volunteers (FCHVs), who are the service provider at the community level. This manual can be used to train community health workers on neonatal sepsis management.

The MINI project and this publication was made possible with financial support from the Saving Newborn Lives program of Save the Children/USA with funds from Bill & Melinda Gates Foundation. JSI Research & Training Institute, Inc./Morang Innovative Neonatal Intervention (MINI) project Nepal. 2009.

Community-Based Maternal and Neonatal Care: Summative Report (PDF, 791 KB)

The community-based maternal and neonatal care (CB-MNC) program of the Nepal Family Health Project (NFHP) was designed to address key health needs of mothers and newborns in Nepal who live in rural locations and have limited or no contact with facility-based health services. This document presents the summary details of a comprehensive monitoring and evaluation effort conducted with assistance from Johns Hopkins University through the NFHP. The studies found a significant increase in skilled birth attendance and dramatic declines in maternal and neonatal mortality. Nepal Family Health Program/JHU/John Snow, Inc., December 2007.