A Review of the Evidence: How Effective is Community-based Primary Health Care in Improving Child Health?

Excitement is rapidly growing concerning the potential for community-based primary health care (CBPHC) to accelerate progress in reducing the tragedy of millions of children dying world-wide each year from readily preventable or treatable conditions. Consequently, a review of the evidence concerning the effectiveness of community-based approaches is timely.

This report to the Expert Panel attempts to summarize the current research findings concerning the effectiveness of CBPHC in improving the health of children in high-mortality, resource-poor settings. The review covers much – but not all – of what is known at present about community-based approaches to improve the nutritional status of children; to improve perinatal and neonatal health; to prevent and treat childhood pneumonia, diarrhea and malaria; to expand coverage of immunizations; to promote handwashing and family planning; to prevent mother-to-child transmission of HIV infection; and to improve child health through non-health interventions.

The review also covers major programmatic achievements in child health during the past 25 years, cross-cutting themes (such as community health workers, equity issues, health system issues, and the broader social determinants of health), and current and emerging programmatic approaches. The full documentation of the review’s findings is still in preparation and will be published as a supplement to the Journal of Health, Population and Nutrition and as a monograph. In addition, several summary articles will soon be submitted to high-profile journals. Drafts of these documents are available to the Expert Panel for its review but have not yet been made publicly available. What follows is a general summary of the findings with recommendations.