DSH 412 Recommendation to reduce mortality rate from 84 per 1000 live biths

MIDLANDS STATE UNIVERSITY

NAME DANIEL MARIJEKI

REGISTRATION No R123694F

FACULTY ARTS

DEPARTMENT DEVELOPMENT STUDIES

DEGREE PROGRAMME BA (HONS) IN DEV STUDIES

MODE OF ENTRY VISITING

MODULE CHILDREN AND DEVELOPMENT IN AFRICA

CODE DSH 412

LECTURER MR R SILLAH

LEVEL 41 YEAR 2014

QUESTION lsquothere is need for reform at all levels of society if Zimbabwersquos child mortality rate is to reduce from present 84 per live birthsrsquo As a development practitioner what reforms would you recommend to various stakeholders in the child health spectrum

Mortality rate reduction requires multi-sectoral approach that

has to encourage contribution of various societal bodies to

make sure that child death rate is reduced Protection

provision and participation of the children must be seen as

central in informing various stake holders in coming up with

programming and mitigation measures that will ensure mortality

rate reduction is achieved In essence there is need to engage

the political social and the economic sectors in formulating

reasonable measures that reduce mortality rate Reduction of

death of live births is not an individual effort but it

entails co-operation of the society government line

ministries availing infrastructure and clinics increase

maternity waiting homes training of midwifery personnel

boosting agricultural production at household level to fight

malnutrition civil society and Ngos food handouts community

education on primary health care use of parliament in sound

policy formulation that are child centred engage

international community in order to ensure there is adherence

legal framework policies that are sound availability of funds

to ensure the complications are dealt with advocacy thus

educating the children and their guardians just to mention a

few things necessary It is the purpose of the preceding

paragraphs to reveal how various organs interact to come up

with sustainable measures that will ensure reduction in

reducing the current 84 death per 1000 live births

Mortality rate is technically defined as the number of deaths

at specified period targeting a certain or specific group of

people It is the ratio of deaths in an area to the population

of that area expressed per 1000 per given year expressed as

death rate fatality rate or mortality rate It is

vulnerability or susceptibility to death that affects large

volumes or numbers of a given population (UNFPA 2008) World

Health Organisation (2014) emphasise that mortality data

indicate numbers of deaths by place time and cause WHOrsquos

mortality data reflect deaths registered by national civil

registration systems of deaths with the underlying cause of

death coded by the national authority Underlying cause of

death is defined as ldquothe disease or injury which initiated the

train of morbid events leading directly to death or the

circumstances of the accident or violence which produced the

fatal injuryrdquo in accordance with the rules of the

International Classification of Diseases

World over there has been a cry to reduce mortality rate among

children and many countries have adopted resolution to reduce

children deaths either from maternal prenatal and other

fatalistic causes by ratification of the millennium

development goals and this mortality rate reduction stand as

millennium goal number 4 Millennium Development Goal 4 (MDG4)

calls for countries to reduce child mortality rates by two-

thirds between 1990 and 2015(UN Millennium Goal 2010 UN

Millennium Report 2005) There is concern that progress

towards meeting this target in sub-Saharan African countries

with generalized epidemics of human immunodeficiency virus

(HIV) infection is being hampered directly by high levels of

mother-to-child HIV transmission and indirectly by illness

and death among mothers with acquired immunodeficiency

syndrome (AIDS) both of which undermine childrenrsquos care

(Adetunji 2000 Ahmad Lopez Inoue 2000) According to

Walker et al (2002) the Joint United Nations Programme for

HIVAIDS (UNAIDS) in the 1990s HIV infection and AIDS

accounted for more than 20 of the total risk of dying before

the age of 5 years in seven countries However the subsequent

scale-up of antiretroviral therapy (ART) programmes and of

national interventions to prevent mother-to-child HIV

transmission offers hope that HIVAIDS control programmes can

help meet the international goal The government must ensure

that the entire population that had tested positive is on its

current therapy programme of free anti-retroviral treatment to

ensure 100 HIV free born babies as well as ensuring health

parents for the nursing and childhood care

Zimbabwean health problems reflect those in other developing

countries where the standard of living is low and housing and

sanitation are inadequate The major cause of infant mortality

can be attributed to preventable diseases such as

gastroenteritis acute respiratory infections and malnutrition

(MHCW2006) In spite of the fact that various efforts have

been made to extend primary health care coverage particularly

in rural areas the scarcity of economic resources impedes the

implementation of many health programmes However only by

maintaining primary health care as a major part of the

countrys development strategy can the needs of both rural and

urban people be met

Political will on the part of government has to be enhanced to

ensure that the child mortality rate is curbed In any state

the political sphere is central since it is the sections that

determines and ensure that child centred policies are crafted

and implemented MNH road man (2005) Child mortality rate can

only be reduced drastically through the support of government

through its intervention programmes backed with sound fiscal

support In Zimbabwe there is evidence government has shown

commitment in curbing the mortality rate through the existence

of the Ministry of Health and Child Welfare This ministry has

been responsible with the unrolling of primary health care

since independence as well as immunisation of children under 5

years However its efforts had been stumbled by in adequate

funding resulting in less than 100 implementation of planned

projects and exercises It is therefore prudent for the

government to channel more money to the Health sector so that

it will move further to improve the child mortality rate The

ministry should set up parallel organs that engage in research

on children diseases and possible vaccination to the

communicable diseases that normally affect children and their

mothers In addition the ministry of health can borrow from

the western world through creating free access to prenatal

and infant care through establishing free toll lines to assist

pregnant women and others seeking information on prenatal

care including referrals to local clinics and physicians The

toll free should be in position to include all dialects or

languages in Zimbabwe eg English Shona Tonga Kalanga

Ndebele just to mention a few Partnership must be created

that provides access to prenatal care for eligible mothers and

health coverage for millions of infants from low-income

families State must expand eligibility and services for

pregnant women and their infants

Perhaps the most important interventions to reduce maternal

and neonatal morbidity

and mortality is to develop and sustain a strong national

Family Planning programme

Designed to prevent unwanted pregnancies and to encourage

child spacing as stipulated in the MNH roadmap (2005) However

the unmet need for contraception has remained static at 13

for the period 1999 to 2006 There is need for government to

ensure that intensive and extensive enforcement of family

planning supported by strong policies is put in place to

ensure curtailing unwanted pregnancies early childhood

pregnancy and policy plans that encourage good spacing giving

the mother time to regain strength and be ready for a next

birth of a health child Mizrahi-Arnaud noted that the

Zimbabwe Nation Family Planning Council has implemented a

community based distribution program which has helped

increase the use of contraceptives to 60 The government

realizes that poor family planning and maternal health are

important contributing factors to childhood mortality and

urges religiously strict countries not to ignore their

importance

In addition the state has to ensure that training of health

personnel especially in midwifery is recommended to ensure

reduction of infant mortality There is need to increase the

ratio of trained personnel against the nursing mothers or

expecting mothers More experienced midwifery personnel will

help to ensure that expert delivery is offered that will

prevent infection during delivery for the newly born babies

as well as to the mother who will look after the baby after

birth Increased numbers of trained or skilled personnel will

help to ensure that all expecting mothers will afford to have

quality attention since the personnel will be tasked to cater

for a certain number of mothers which will ensure that they

have efficient service A combined report by Government of

Zimbabwe and United Nations report(2010) revealed that public

sector human resources for health vacancy levels (December

2009) were at unacceptable levels of 50 percent for doctors

54 percent for environmental health technicians over 80

percent for midwives 47 percent for nursing tutors and over

50 percent for pharmacy radiology and laboratory personnel

Health management has weakened as a result of high attrition

rates of experienced health service and programme managers

This has an impact on supervision and monitoring and is

evidenced by reduced quality of service provision

Furthermore it is upon governmentrsquos political will to ensure

that primary health care and vaccination or immunisation is

effective as well as ensuring that efficient methods of

reducing mortality rate among children are employed There is

need to engage the community and other international community

such Unicef Save the Children and Red cross that are child

centred in approach as noted by Mizrahi-Arnaud (2009) The

government must carry the obligation of funding or sourcing

funds from international organisations to ensure that primary

health care programmes reach each door step of every household

irrespective of geographical location eg urban or rural

Community information dissemination must be done through

looking at the specific requirements of the community in

other word it has to be community specific Children are also

to be treated and vaccinated for free to curb the spreading of

the diseases that normal affect children such as diarrhoea

measles and polio just to mention a few Government is

central in educating and equipping the clinics hospitals with

required personnel and medication that will help to fight most

of life threatening diseases Ratio of patient to nurse or

doctor must be such that no patient will die in the queue

waiting to get service or treatment There is need to ensure

that user fees scrapping be extended to the mothers as long as

they will be still nursing children below the age of five

(Khupe 2010) If the mother fall sick while still looking

after the under five she has to be treated so that she remains

health thus affording her time to spend on her siblings than

being on a stretcher bed leaving children with no one to care

after

In addition government will or political will should be

further extended to infrastructure development Infrastructure

and facilities be availed to the society or community The

government must make sure that number of service centres be

increased to the extent that the distance to the nearest

hospital or clinic has to be less than ten kilometres or be

set at ten kilometres in rural areas The other cause of

deaths in children is attributed to the nature of roads and

their quality especially in rural areas and non availability

of maternity waiting homes which lead women to present

themselves late There is need for government to intervene by

ensuring that all the roads connecting to hospitals and

clinics are user friendly by so doing it will improve

mobility when people want to seek treatment Bad roads can

contribute to severity of illness since some will be so bad

that it will take long hours to travel to the nearest clinic

in case of emergence especially in rural areas On this matter

Ministry Transport will have to consider request made by

Ministry of Health in rehabilitating roads that lead to their

health centres this is where the multi-sectoral approach chip

in

On a social perspective the societyrsquos cultural beliefs and

religious beliefs need to be merged well with the government

policies in order to help fight the reduction of child

mortality rate It is the social responsibility of both the

society and government to ensure that Some religious beliefs

in Zimbabwe especially among the apostolic sects ldquoThe Johane

Marange religionrdquo have a religious belief that they should not

seek western medicine and will solely rely on their religious

beliefs for delivery and treatment of early childhood

sicknesses Some of the purported means and beliefs are

detrimental to the survival of children (National Health

Strategy of 2005) On the other had the traditional society

have their beliefs and traditional medicines they believe are

to be given for child treatment some of them might be dirty or

in immeasurable quantities that will affect the body system of

the children resulting to death In addition there are local

or community midwives who also use their old dirty methods to

provide delivery services such methods are primitive and

backward so much that they will lead to health complications

of the mother as well as the child It is therefore prudent

for the government of Zimbabwe implement participatory

approach in trying to merge the religious beliefs and

traditional beliefs of the communities in coming up with a

solution to the care and treatment of children While

vaccination and application of laboratory tested medicine is

viable the government should not completely rule out the

traditional and religious methods since they worked before the

advent of new system There is need to consult and create

religious and traditional healing centres that are formed

through the community contribution and supervision of

government to ensure WHO (World Health Organisation) standards

are adhered to in this situation no one will refuse to get the

child treated

Furthermore Mapara(2009) embraces the use of indigenous

knowledge systems where it cannot be refuted that IKs or ethno

science as described by Mapara (2009) can also be employed in

health care of children where it is important to work towards

child mortality rate reduction Though indigenous knowledge on

medicines lacks specifications and composition but it is still

valid in manufacturing medicines since today some medicines

are born out of the natural herbs WHO report of 1999 The

society must not be detached from its origins and beliefs A

deviation from the culture belief and way of life will yield

rebellion or resistance where community will not be eager to

administer medication they are not certain of on their

origins more so detached from their indigenous knowledge

Ownership of health system is enhanced by acknowledging the

traditional indigenous system of the society The government

has to make sure that in its highest book of law the

constitution they must embrace the use of the indigenous

treatment method This can also be done by allowing

participation of community on how they want their knowledge

systems to be embraced in the modern day treatment cycle The

government can move further by opening laboratories that work

hand in hand with traditional knowledge In this circumstance

the scientists will be working hand in hand with those

traditional experts in drug research and manufacturing

Economically if it succeed and get WHO approval and

recognition the drugs will be cheaper which will be a

blessing to expecting mothers as well as nursing mothers since

they will be able to access either free or cheap treatment for

themselves and their children

On the other hand poverty is central in leading high infant or

children deaths Children will die and suffer from

malnutrition disease because their parents cannot afford to

put a food that is nutritious due lack of endowmentsrsquo A

poverty stricken society is harmful to development as well as

to the care of future human resources (children) that would

stir the fortunesrsquo of their nation and life Sen (1982) noted

that poverty reduces the entitlementsrsquo of a family and this

will lead to a number of life threats such as hunger disease

illness just to mention a few There is need to seriously

consider investment projects that will alleviate access of

people to entitlementsrsquo The state has to seriously consider

their investment policy that plays part in inviting foreign

direct investment thus creating employment (Min of

Finance2004) The current indigenization or black empowerment

policy which seek to top cede 51 shares to locals and 49 to

partners or foreign investors is not investor friendly

considering the comatose economy we are in In as much total

control is viable the government must put the needs of

nationals first Outside investment policy the state must

ensure that projects they engage in as government or that

international community bring are sustainable to ensure that

poverty is eradicated Dependency nurtured projects or

livelihoods must not be given space

Community advocacy on health issues is also another important

area that the country needs to improve on Communities must be

availed with information centres that are used as the media to

information sharing and dissemination For instance these

community centres have to be both the custodian of society

beliefs and tradition Community is more attached to a

project that they influenced These community centres are to

be used to unite the community through helpful education to

young girls as information is given on the dangers of early

pregnancy since these will have a direct impact on the health

of both the mother and the child to be conceived It will be

also an opportunity to give knowledge to the community on some

of the traditionsrsquo on early childhood marriagesrsquo (kuzvarira)

such practises will keep posing a threat to the children born

out of young girls thus increasing the death rate A website

wwwhhsgovnewspress2002presteenpreghtml noted that

Infants born to teenage mothers are at higher risk of being

born low birth weight babies and have a higher mortality rate

The same community gathering will help to pass information

reducing teen pregnancy as well as on good diets as well as

typersquos food to eat that will help to fight malnutrition which

normally causes deaths in children

Housing is yet another area that the government of Zimbabwe

need to improve The pace at which the government has moved in

terms of housing since independence is not adequate when

compared to the dynamics taking place in population change

The ministry of local government has to ensure that the number

of occupants at any given house in urban settings does not

exceed 5 families at any given time (MHCW 2001) Congestion

on houses results into high levels of unhygienic practises and

this has an health impact to children since they are the ones

who can easily catch diseases that come as a result of

congestion such as diarrhoea typhoid cholera just to mention

a few Congestion will make it difficult to control standard

cleanliness of water and the living environment hence some

diseases such as airborne diseases and water born diseases

will affect children who have a weaker immune system as

compared to adults The government has to ensure that housing

units are increased with an average occupation of two families

on a given house so that children are spared from diseases

that are spread through congestion which normally results into

high death rates of the children Research and commitment to research funding is one area that

the government of Zimbabwe must move towards Research on

types of diseases vaccination and other methods of curbing

child illness is central to child mortality rate (MNH

report2005) Diseases according to medical researchers they

are either increase their viciousness according to

geographical locations In some regions the same diseases is

said to be vicious and can lead to fatal incidents if the

dosage is little A case in point is yellow fever in Tanzania

is deadly as compared to yellow fever in Zimbabwe to the

extent that countries within the region and the Tanzanian

government will ensure that yellow fewer injection is

administered to anyone who would have visited Tanzania for the

first time Research is very important and crucial since it

informs the country of the most prevalent children diseases

that normally affect in both rural and urban setting This

will be easy to deal with diseases that affect children Case

in point children in urban settings are more likely to suffer

from dehydration diseasesrsquo as result of unclean water which

sometimes is not well treated due to lack of medication

whereas in rural setting children can be more prone to

bilharzias from stagnant water sources In this case sound

research centres will inform the treating centres with

diagnostic clue if they trace history of place of stay of

children before they become sick or ill

On another note child mortality rate is not only tied to

diseases and malnutrition but children death rate is also

contributed by motorists In this respect there is need for

government to step and formulate legislation that is stern to

motorists who carelessly cause the death of young children

There is need to put place laws that stipulate the behaviour

that should be worn by those who ferry children as they will

be going to kindergarten school (Unicef2006) For instance

motorists who travel with children in the front passenger

seats must be fined or charged because it will be risk and

exposing them to more harm or death if an accident occurs

Laws that enforce use of baby safety as the case in Iran as

encouraged by Unicef child chairs as well as child lock keys

need to be enforced in Zimbabwe Iran is one such country that

has put in place legislation pertaining child safety The

Zimbabwean society is moving to a situation where vehicles are

increasing meaning to say in the next decade use of vehicles

will be the order of the day but such development will also

pose risk to children if motorists are not refrained by

penalty In recent months newspapers were awash with news of

a 5 year old boy belonging to a vendor who resides in Budiriro

Harare high density who was rammed by a commuter omnibus

driver as he was fleeing from police Such is the case if

there was a known legislation that causing death to children

is a punishable offence the motorists would exercise caution

In addition UN (2006) noted that child mortality rate

reduction cannot be successful without the economic support

either through fiscal allocation or foreign direct investment

Currently Zimbabwean situation is pathetic where the economy

is suffering from liquidity crunch as well as underperforming

industries characterised by lose of jobs and retrenchments

All programmes that range from infrastructure development

food security vaccination programmes medicines just to

mention a few mattering aspects that cause child death if they

lack need funding The economy will therefore become the

cornerstone for all these projects to roll so that

malnutrition is dealt with and many other communicable

diseases that causes death to children (UNFPA 2006) The

economy needs investors and investor friendly policies must be

engaged Currently the Zimasset blue print which is purported

to turn around the economy fortunes of the country has been a

failure since its inception instead of creating jobs companies

are closing jobs are being lost In terms of food security the

government is struggling to buy maize despite a bumper

harvest There has been discord in the ministry Herald of

Agriculture as reported by Herald 2014 that the deputy

minister paddy Zhanda directed farmers to private buyers

citing lack of funds On the other had the Minister Made

purports that 5million has been sought Failures to secure

food will lead to food deficiencies that will impact on

nursing mothers and their children leading to death of the

children if they lack enough balanced diet on food they

consume

More over agricultural production has to be boosted to ensure

that the country as a whole as well as at household level is

food secure Agriculture is the backbone of the agrarian

economy of Zimbabwe hence there is need to fund it since good

production will lead to trickle effects to many sectors of the

economy Although land reform was done there is still a lot to

be done on the land to ensure that the farmers contribute to

health issue of the children Agriculture has to be

transformed in such a way that production of the most need

crops that are health is produced Unicef( 2006) recommended

use good nutrition to fight malnutrition in the country

adhering to the grouped dietary food groups such as

carbohydrates proteins vitamin and others Availability of

various nutritious crops like beans vegetable peas carrots

lettuce potatoes just to mention a few as well as the

boosting dairy farming ensure that nutritious food is

available as advocated by Longwe (1986) The ministry of

health and Agriculture have to partner in rolling out training

and advocacy programmes that encourage farming of nutritious

crops while the agriculture sector help with farming research

knowledge as well as planting about caring for the crops The

combined effort of these ministries will help to reduce

poverty as well as fight disease through health foods hence

child mortality rate is curtailed At the present moment there

is no adequate food production taking place so the government

has to ensure that training of farmers takes place on the

ground coupled with agricultural research knowledge to guard

against pests and weevils that might destroy the crops which

are intended to benefit the children and their mothers to

fight malnutrition inclined deaths

Water and sanitation in both rural and urban spheres need to

be stepped further to ensure that the communities are using

clean and safe water as well as good toilets to avoid the

outbreak of cholera and typhoid which are life threatening

diseases to the children owing to their immune system that is

still at infancy where adapting or resisting the impact is

next to none (MHCW2001) Community engagement is necessary in

this aspect The community can draw lessons from Ghana as

noted by Mackay K and Gariba (2000) especially in the

rural Zimbabwe can help in coming up with designs for

sanitation purposes as well as position to drill boreholes In

urban centres the community through the elected councillors or

a community committee must work hand in hand with city

authorities to ensure that resources are allocated to the

sewer reticulation maintenance and water treatment If water

is clean as well the environment it helps to curb the most

communnicable diseases which normal cause death in children

For instance rural areas should move further in availing them

with running water which in health circles is believed to safe

since it not stagnant and its chances o being contaminated a

less

It is crystal from the ongoing discussion that children

mortality rate is not a one sector issue but it is intricate

to various sectors hence it calls for a multi-sectoral

approach that are participatory centred since every sectors

contribution is key to the reduction of children death at any

given point Moreover the causes of increase in children

mortality rate can be controlled hence it calls for a

democratic state that has people or the nation at heart to

unroll projects and craft laws that are child centred as well

as protecting and providing for the needs of the future

generation Child mortality can be reduced depending on the

willingness of a state to supervise its entire line ministry

in implantation and execution of goals as well as targetsrsquo

that will see the life of the children being spared

Communities should be part and parcel of the planning and

implantation in order to enhance sense of ownership of all

government projects against increase in children death (MHCW

2001)

Reference List

Longwe SH(1986) ldquo WomenNutrition and Development The

Need for Increased Control by WomenrdquoPaper Presented to the

Provincial Workshop on Nutrition and Household

ProductionChipataAugust 25-28 1986

Mackay K and Gariba (2000) The Role of Civil Society in

Assessing Public

sector Performance in Ghana Proceedings of a Workshop

Evaluation Capacity

development

Ministry of Health and Child Welfare Reproductive Health Service Delivery

Guidelines Harare

Republic of Zimbabwe 2001

MaparaJ(2009) Indigenous Knowledge sytem in Zimbabawe

Juxtaposing Post colonial Theory

Mizrahi-Arnaud G World Health Organization (WHO)

Topic One Reducing Mortality Rates and Increasing Life

Expectancy

Zimbabwe

SenA (1982) Povety and Famines An Essay on Entitlement

LondonOxford university Press

UNFPA Government of ZimbabweUNFPA Country Programme Action Plan 2007 1048753

2011UNFPA September 2006

UNICEF Government of ZimbabweUNICEF Country Programme Action Plan 2007 1048753

2011

UNICEF September 2006

UNICEF Programming for Safe Motherhood Guidelines for Maternal and Neonatal

Survival

New York UNICEF 1999

United Nations Zimbabwe United Nations Development Assistance Framework 2007

1048753 2011

Harare Office of the Resident Coordinator 2006

World Health Organization Country Cooperation Strategy 2003-2007 Republic

of Zimbabwe

January 2004

World Health Organization Mother 1048753 Baby package Costing Spreadsheet

Geneva World Health

Organization 1999

World Health Organization Mother-baby Package Implementing safe

motherhood in countries

Maternal Health and Safe Motherhood Programme Division of Family and

Health WHO

Geneva 1996 p 11

WHO The World Health Report 2005 Make Every Mother and Child Count Geneva

WHO

(2005)

WHOAFRO Road Map 1048753 African Union resolves to tackle maternal mortality

Reproductive

Health Newsletter August 2004

Initiatives Inc Human Resources study 1048753 conducted for the Ministry of Health and

Child

Welfare (Zimbabwe) Initiatives Inc Boston Massachusetts 2000

Ministry of Finance and Economic Planning Estimates of Expenditure

(199710487532004)

Government of Zimbabwe Harare (2004)

LEVEL 41 YEAR 2014

QUESTION lsquothere is need for reform at all levels of society if Zimbabwersquos child mortality rate is to reduce from present 84 per live birthsrsquo As a development practitioner what reforms would you recommend to various stakeholders in the child health spectrum

Mortality rate reduction requires multi-sectoral approach that

has to encourage contribution of various societal bodies to

make sure that child death rate is reduced Protection

provision and participation of the children must be seen as

central in informing various stake holders in coming up with

programming and mitigation measures that will ensure mortality

rate reduction is achieved In essence there is need to engage

the political social and the economic sectors in formulating

reasonable measures that reduce mortality rate Reduction of

death of live births is not an individual effort but it

entails co-operation of the society government line

ministries availing infrastructure and clinics increase

maternity waiting homes training of midwifery personnel

boosting agricultural production at household level to fight

malnutrition civil society and Ngos food handouts community

education on primary health care use of parliament in sound

policy formulation that are child centred engage

international community in order to ensure there is adherence

legal framework policies that are sound availability of funds

to ensure the complications are dealt with advocacy thus

educating the children and their guardians just to mention a





























































urban people be met





















































importance




















































after





















in

































child treated












































































































































































consume



















































less


















2001)

Reference List






Assessing Public


Evaluation Capacity

development


Guidelines Harare






Expectancy

Zimbabwe






2011



Survival



1048753 2011



of Zimbabwe

January 2004


Geneva World Health

Organization 1999




Health WHO

Geneva 1996 p 11


WHO

(2005)


Reproductive



Child



(199710487532004)






























































urban people be met





















































importance




















































after





















in

































child treated












































































































































































consume



















































less


















2001)

Reference List






Assessing Public


Evaluation Capacity

development


Guidelines Harare






Expectancy

Zimbabwe






2011



Survival



1048753 2011



of Zimbabwe

January 2004


Geneva World Health

Organization 1999




Health WHO

Geneva 1996 p 11


WHO

(2005)


Reproductive



Child



(199710487532004)

































importance




















































after





















in

































child treated












































































































































































consume



















































less


















2001)

Reference List






Assessing Public


Evaluation Capacity

development


Guidelines Harare






Expectancy

Zimbabwe






2011



Survival



1048753 2011



of Zimbabwe

January 2004


Geneva World Health

Organization 1999




Health WHO

Geneva 1996 p 11


WHO

(2005)


Reproductive



Child



(199710487532004)
































after





















in

































child treated












































































































































































consume



















































less


















2001)

Reference List






Assessing Public


Evaluation Capacity

development


Guidelines Harare






Expectancy

Zimbabwe






2011



Survival



1048753 2011



of Zimbabwe

January 2004


Geneva World Health

Organization 1999




Health WHO

Geneva 1996 p 11


WHO

(2005)


Reproductive



Child



(199710487532004)


































child treated












































































































































































consume



















































less


















2001)

Reference List






Assessing Public


Evaluation Capacity

development


Guidelines Harare






Expectancy

Zimbabwe






2011



Survival



1048753 2011



of Zimbabwe

January 2004


Geneva World Health

Organization 1999




Health WHO

Geneva 1996 p 11


WHO

(2005)


Reproductive



Child



(199710487532004)























































































































































consume



















































less


















2001)

Reference List






Assessing Public


Evaluation Capacity

development


Guidelines Harare






Expectancy

Zimbabwe






2011



Survival



1048753 2011



of Zimbabwe

January 2004


Geneva World Health

Organization 1999




Health WHO

Geneva 1996 p 11


WHO

(2005)


Reproductive



Child



(199710487532004)










































less


















2001)

Reference List






Assessing Public


Evaluation Capacity

development


Guidelines Harare






Expectancy

Zimbabwe






2011



Survival



1048753 2011



of Zimbabwe

January 2004


Geneva World Health

Organization 1999




Health WHO

Geneva 1996 p 11


WHO

(2005)


Reproductive



Child



(199710487532004)






2001)

Reference List






Assessing Public


Evaluation Capacity

development


Guidelines Harare






Expectancy

Zimbabwe






2011



Survival



1048753 2011



of Zimbabwe

January 2004


Geneva World Health

Organization 1999




Health WHO

Geneva 1996 p 11


WHO

(2005)


Reproductive



Child



(199710487532004)







2011



Survival



1048753 2011



of Zimbabwe

January 2004


Geneva World Health

Organization 1999




Health WHO

Geneva 1996 p 11


WHO

(2005)


Reproductive



Child



(199710487532004)



Health WHO

Geneva 1996 p 11


WHO

(2005)


Reproductive



Child



(199710487532004)


DSH 412 Recommendation to reduce mortality rate from 84 per 1000 live biths

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Transcript of DSH 412 Recommendation to reduce mortality rate from 84 per 1000 live biths