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Essential health, education and other service disruptions arising from the COVID-19 pandemic risk reversing some of the hard-won gains in improving child survival over the past 40 years. Although children have milder symptoms of COVID-19 disease than adults, pandemic control measures in many countries have disrupted health, education and other services for children, often leaving them without access to birth and postnatal care, vaccinations and early childhood preventive and treatment services. These disruptions mean that the SARS-CoV-2 virus, along with climate change and shifting epidemiological and demographic patterns, are challenging the survival gains that we have seen over the past 40 years. We revisit the initiatives and actions of the past that catalyzed survival improvements in an effort to learn how to maintain these gains even in the face of today's global challenges. [ABSTRACT FROM AUTHOR]

Household environmental health hazards or simply household health hazards (HHH) are pathogens and chemicals in the household that can cause health problems. In this study, we assess their effect on under-five mortality (U5MR) in 12 sub-Saharan African countries, using data from the Demographic and Health Surveys. Referring to the principal component analysis approach, we measure the HHH by the following indicators: source of water and its location, type of toilet facility, flooring material, type of wall, type of roof and type of cooking fuel. In an unadjusted multilevel discrete-time hazard model, we find that HHH affect positively child mortality in 9 of the 12 countries, whereas this effect presented itself only in 4 countries when controlling for other covariates. However, using a model with interaction between the child’s age and HHH, we find it interesting that increasing levels of the HHH are consistently associated with increasing risk of death during 24–59 months after birth in eight countries. Future researches are needed to decipher the mechanisms behind these findings, whether explained by the accumulation of hazardous environment in early childhood, or frequent contact with noxious environments at a later stage of childhood, or both. [ABSTRACT FROM AUTHOR]

In Nigeria, childhood mortality is very high, with almost a million children dying each year. A fifth of these die from vaccine-preventable diseases. The role of immunisation in preventing childhood morbidity and mortality is widely recognised. Unfortunately little, if any, account has been given of the law’s role in immunisation in legal discourse in Nigeria. Yet recent steps have been taken at both federal and state levels to compel immunisation using the instrument of legislation. For instance, the Child Rights Act, a domestication of the Convention of the Rights of the Child, passed in 2003 includes provisions compelling immunisation. Also, several states in Nigeria like Jigawa, Niger and Katsina States, have recently enacted legislation that makes childhood immunisation compulsory under the law. These pieces of legislation criminalise refusal to immunise children and also public statements that discourage immunisation. I identify the challenges that limit or obstruct uptake of immunisation in Nigeria and ask what role the law can play in providing solutions to these challenges. I examine the ways in which the law has been engaged to promote immunisation, the impact of law and the limits of legislative intervention. I also suggest ways to improve the law’s effectiveness in this essential public health matter. [ABSTRACT FROM PUBLISHER]

Through a systematic review of the literature, this article summarizes and evaluates evidence for the effectiveness of mass media interventions for child survival. To be included, studies had to describe a mass media intervention; address a child survival health topic; present quantitative data from a low- or middle-income country; use an evaluation design that compared outcomes using pre- and postintervention data, treatment versus comparison groups, or postintervention data across levels of exposure; and report a behavioral or health outcome. The 111 campaign evaluations that met the inclusion criteria included 15 diarrheal disease, 8 immunization, 2 malaria, 14 nutrition, 1 preventing mother-to-child transmission of HIV, 4 respiratory disease, and 67 reproductive health interventions. These evaluations were then sorted into weak (n =33), moderate (n = 32), and stronger evaluations (n = 46) on the basis of the sampling method, the evaluation design, and efforts to address threats to inference of mass media effects. The moderate and stronger evaluations provide evidence that mass media-centric campaigns can positively impact a wide range of child survival health behaviors. [ABSTRACT FROM PUBLISHER]