Saving Lives through Tried and Trusted methods: Evaluation the Intervention of the International Committee of the Red Cross
Summary of published paper
A retrospective study on the under five
mortality of children was conducted in Meringue, a district of central
Mozambique in October 1994. During the civil war in this country, between
1975-91, immunisations stopped in many areas while epidemics, malnutrition
and famines struck most of the country. Humanitarian organisations tried
to help reorganise the health services even before the signing of the peace
agreement. The ICRC implemented one such programme in Maringue district
from the end of 1991. The survey conducted in `1994 set out to measure
trends in mortality during the war period and to evaluate the effect of
the ICRC intervention on child survival.
The ICRC intervention in the district involved
reorganising health services, undertaking EPI vaccinations and vitamin
A supplementation. The distribution of vitamin A was introduced in
1993. It was given at first EPI contact and then every six months. Children
aged 1-4 years received 200,000 international units and children less than
1twelve months of age received 100,000 IU.
During the civil war period (1975-91) mortality
increased rapidly reaching a peak of 473 per 1000 in 1986. It declined
again afterwards reaching a plateau of 380 in 1991. The ICRC health intervention
further reduced mortality to 269 per 1000 in 1994. This was mostly attributable
to the vaccinations and vitamin A supplementation. The mortality decline
during the intervention period was highly significant and could not be
explained by the trends in the preceding three years. It could be confirmed
by analysis of changes in mortality by cause of death which showed that
90% of the changes from 1991-4 were attributable to a decline in mortality
from measles, tetanus, and malnutrition, the target diseases of the intervention.
In contrast, mortality from other causes of death did not change over the
same period.
Among the interventions conducted by the
ICRC, the EPI programme seems to have been most successful. Together with
vitamin A supplementation, it contributed to most of the 28% mortality
decline observed during the three years of the project. The authors of
the study concluded that this shows the potential of simple interventions
to improve child survival in such severe circumstances.
Reference:
Effects of the Civil War in Central
Mozambique and Evaluation of the Intervention of the International Committee
of the Red Cross: Garenne. M et al (1997), Journal of Tropical Paediatrics,
vol. 43, pp 318-323
Taken from Field Exchange Issue 4, June 1998
http://fex.ennonline.net/4/saving