Background: The EPI program in Ethiopia has been implementing since 1980s, however there is substantial number of children's not immunized in pastoralist communities. The GAVI-CSO support Project Bridge the gap in reaching the unreached children's for immunization through CSOs collaborative effort. Objective: To assess the contribution of GAVI-CSO support project on improving immunization coverage among children aged 12-23 months old and knowledge of mothers/cares takers on VPD. Methods: The survey was conducted in 22 project Woredas using a cross-sectional method with a 30 by 10 modified WHO EPI cluster sampling technique for interviewing mothers/care takers with target children. Data was collected using standardized structured questioner which further entered and analyzed using EpiData entry II and STATA. Results: Vaccination status of children's was significantly increased compared to the baseline (P<0.001) with a decline on polio 0 (P=0.006) however, the coverage decreases by owning vaccination card. On the other hand, Knowledge of mothers on VPD was declined compared to the baseline except pneumonia and meningitis which significantly increased. Recommendation: Needs to sustain the immunization coverage in the areas using the established sense of ownership. Immunization cards should be retained at home by discussing with the health institutions involved in vaccination. There is a need to strengthen knowledge of mothers on vaccine preventable diseases and timing of subsequent vaccinations through continuous, targeted information, education and communication (IEC) interventions.

Background: According to UNICEF, the Democratic Republic of Congo (DRC) has the 8^th highest U5MR at 119/1,000.  In 2014, a Demographic and Health Survey was completed in DRC.  There are only 8 publications on PUBMED from the 2007 DHS and 0 from 2014; whereas, there is much greater use of DHS data in many other countries. In this analysis we review factors associated with U5MR.

Hypothesis: There will be a clinically relevant and statistically significant association between childhood motality and the following: FBO health zone co-management, gender, year of birth, parity, rural/urban, maternal BMI, province, bed net use, wealth index and number of wives in the family.

Methods: DHS 2014 data was used along DHS guidelines for weighting to construct a logistic regression model with death by 5 years old as the outcome variable and the above-mentioned indepedent factors.  STATA 11.1 (StataCorp) was used.  Individual Kaplan Meier Survival curves were used for exploration.  Children with a current age of <60 months at the time of the interview were included.

Results: Parity (OR1.56, p=0.008), Provinces (Bandundu (0.25, p=0.007); Equateur (OR=0.23, p=0.004); Kasai-Oriental (OR=0.33, p=0.041); Nord-Kivu Province (OR=0.28, p=0.027); Sud-Kivu (OR=0.056, p=0.015), DHS Wealth Index (OR=.056, p=0.002), maternal age (OR/year=1.03, p=0.013) were all statistically significant. Gender (OR=0.79), FBO co-management (OR=0.79), urban/rural (OR=0.83), year of birth (OR=1.33), bed net use (OR=0.77), number of wives (OR=1.26), and maternal BMI (OR/unit=1.03) were not statistically significant.

 Discussion: Parity is predictive of higher mortality. Several provinces perform better than the index province of Kinshasa.  Wealth Index and maternal age have strong associations with mortality.  BMI was not associated with childhood mortality.  FBO co-management status, gender, bed net use, and urban/rural status all had strong associations; however, they were not statistically significant.  It is important to continue to evaluate predictors of childhood mortality and modify health delivery strategies accordingly.

background: A four-year integrated child survival (CS) and early childhood development (ECD) project sought to improve maternal and child health and child development outcomes in a pilot site in Rwanda.  A mixed-methods evaluation explored whether the project achieved its objectives and equitably provided services designed to support individual- and community-level benefits.

methods: Knowledge, Practice, and Coverage (KPC) survey data measured household characteristics, maternal and child health behaviors and practices, and program exposure among baseline and endline cross sections of women with a child under two years of age in intervention and comparison sites. Endline qualitative data were collected via focus group discussions with community health workers and participating mothers.

results: Based on qualitative data, despite equitable access to the project and a policy whereby no one was turned away, poorer families were inclined to self-regulate their participation when unable to contribute to project costs. Child absence from ECDs also was attributed to poor health, linked to an inability to afford health insurance and seek care. Poorer families reportedly had a harder time understanding instructions, maintaining food security and purchasing supplies for high nutrient feeding and ECD activities. There remained significant differences at endline in CS-related KPC outcomes by socio-economic status, particularly for indicators of child underweight and stunted, treatment access for childhood illnesses, and contraceptive use.

conclusions:  The intervention had limited ability to fully address poverty-related inequities on child survival outcomes. Future efforts should incorporate adaptive and participatory approaches benefitting the most poor, in conjunction with poverty reduction programming.  

purpose: To determine the effectiveness of a community-based behavior change campaign in Petit-Goâve, Haiti.

background: A gap in fulfilling the Millennium Development Goals’ health agenda for children includes interventions preventing neonatal mortality. Sepsis is the third leading cause of neonatal death worldwide. Bacterial infections in the umbilical cord (omphalitis) can lead to sepsis and neonatal death. Simple, affordable interventions may prevent such deaths. The WHO recommendation of chlorhexidine (4%) application to the newborn’s umbilical stump can decrease omphalitis and sepsis.  Benefits of chlorhexidine use may be important in Haiti where neonatal mortality rate is 25.5 per 1000 live births  and 63 % of deliveries occur at home. Neonates incur a higher risk for cord infection with home delivery. Cultural beliefs strongly influence newborn care including unhygienic and traditional cord care practices. Acceptability for introducing a new cord care practice in Petit-Goâve, Haiti was demonstrated.

methods: A controlled trial was used to determine differences in mother’s cord care practices between those instructed in chlorhexidine cord application prenatally and those who received no prenatal cord care instruction. A verbal questionnaire was given to consenting mothers at 1 and 4 weeks post-delivery. Descriptive statistics and unadjusted and adjusted analyses used to determine differences in mother’s cord care practices between intervention and control groups. [Data analysis to be completed 6/2015 n=200].

findings/recommendation: If a non-traditional cord care practice instructed to mothers by community health providers is successful, this culturally relevant strategy can be used for improving other aspects of newborn care globally.

The association between duration of breastfeeding and child survival is strong and positive.  Breastfeeding is one of the most effective crosscutting interventions to improve child health status. Breast milk provides a child with adequate nutrient intake and immunologic defense, as well as helps to regulate birth spacing. With benefits of breastfeeding well documented, many of the developing countries still continue to report lower levels of breastfeeding. These lead to recurrent diarrhea, Acute Respiratory Infections (ARI), and other infections resulting poor nutritional status of children.

The objectives of this study are multifold. (i) examine existing policies on breastfeeding across developing countries, (ii) study the impact of socio-economic determinants on duration of breastfeeding across low-income countries, and (iii) recommend policy actions that would enhance complementarity in the roles of breastfeeding on one hand and its role in assuring continued progress in child health status on the other. The study is based on low-income countries where Demographic and Health Survey (DHS) data are available for the year 2005 and beyond. Ordinary least squares is used to predict breastfeeding length using socio-economic variables (wealth quintiles, maternal education, and female autonomy). Length of breastfeeding is the response variable while control variables includes age, sex of the child, and use of antenatal services. Preliminary results show that length of breastfeeding is strongly associated with use of antenatal services, and women’s autonomy.  Positive breastfeeding campaigns can accelerate improvement in child health status especially among countries who are likely to fail in achieving child health related MDGs.