Child Survival Revolution


In 1986, the United Nations Children's Fund (UNICEF) announced a worldwide campaign to prevent unnecessary child deaths called the “child survival revolution.”


Every year in the developing countries of the world, some 11 million children under the age of five die of common infectious diseases. Most of these children could be saved by simple, inexpensive, preventative medicine. Many public health officials argue that it is as immoral and unethical to allow children to die of easily preventable diseases as it is to allow them to starve to death or to be murdered. The child survival revolution campaign is based on four principles, designated by the acronym GOBI.

“G” stands for growth monitoring. A healthy child is considered a growing child. Underweight children are much more susceptible to infectious diseases, retardation, and other medical problems than children who are better nourished. Regular growth monitoring is the first step in health maintenance.

“O” stands for oral rehydration therapy (ORT). About one-third of all deaths under five years of age are caused by diarrheal diseases. A simple solution of salts, glucose, or rice powder and boiled water given orally is almost miraculously effective in preventing death from dehydration shock in these diseases. The cost of treatment is only a few cents per child. The British medical journal Lancet, called ORT “the most important medical advance of the century.”

“B” stands for breastfeeding. Babies who are breastfed receive natural immunity to diseases from antibodies in their mother's milk, but infant formula companies persuaded mothers in many developing countries that bottle-feeding is more modern and healthful than breastfeeding. Unfortunately, these mothers usually do not have access to clean water to combine with the formula, and they cannot afford enough expensive synthetic formula to nourish their babies adequately. Consequently, the mortality among bottle-fed babies is much higher than among breastfed babies in developing countries.

Burkina Faso provides an excellent example of how a successful immunization campaign can be carried out. Although this West African nation is one of the poorest in the world (annual gross national product per capita of only $140), and its roads, health care clinics, communication, and educational facilities are either nonexistent or woefully inadequate, a highly successful “vaccination commando” operation was undertaken in 1985. In a single three-week period, one million children were immunized against three major diseases (measles, yellow fever, and meningitis) with only a single injection. This represents 60 percent of all children under age 14 in the country. The cost was less than $1 per child.

In addition to being a moral issue, reducing child mortality may be one of the best ways to stabilize world population growth. There has never been a reduction in birth rates that was not preceded by a reduction in infant mortality. When parents are confident that their children will survive, they tend to have only the number of children they actually want, rather than “compensating” for likely deaths by extra births. In Bangladesh, where ORT was discovered, a children's health campaign in the slums of Dacca has reduced infant mortality rates 21 percent since 1983. In that same period, the use of birth control increased 45 percent and birth rates decreased 21 percent.

Sri Lanka, China, Costa Rica, Thailand, and the Republic of Korea have reduced child deaths to a level comparable to those in many highly developed countries. This child survival revolution has been followed by low birth rates and stabilizing populations. The United Nations Children's Fund estimates that if all developing countries had been able to achieve similar birth and death rates, there would have been nine million fewer child deaths in 1987, and nearly 22 million fewer births.

Despite the successes of the child survival revolution, a decline in medical infrastructure, drought and resultant famine, and conflict in areas of the developing world led to a continued persistence in child mortality. In 2007, a new effort called the Partnership for Maternal, Newborn, and Child Health, consisting of UNICEF, the World Health Organization, the World Bank, and the United States Agency for International Development (USAID) was launched. Several independent foundations and non-government agencies (NGOs) have joined the Partnership, which coordinates efforts to focus on the UN's Millennium Development Goal number four, reducing child mortality. The Partnership aims to lower childhood mortality rates to 31 out of 1,000 children by 2015, a reduction of two-thirds of child mortality rates in 1990. The partnership focuses on delivering a set of key interventions in partnership with governments including insecticide treated bed nets, oral rehydration and nutrition supplementation, vaccinations, medications against common childhood diseases, clean drinking water, vitamin supplementation, and building a continuum of care for mothers and children.

See also Cholera ; Communicable diseases ; Diphtheria ; Drought ; Famine ; Meningitis ; Polio ; Whooping cough ; Yellow fever .



Boone, Peter, and Zhaoguo Zhan. Lowering Child Mortality in Poor Countries: The Power of Knowledgeable Parents. London: Centre for Economic Performance, 2006.

A Fair Chance at Life: Why Equity Matters for Child Mortality: A Save the Children Report for the 2010 Summit on the Millennium Development Goals. London: International Save the Children Alliance, 2010.

Franz, Jennifer S. Child Mortality, Poverty and Environment in Developing Countries. St. Andrews, Scotland: University of St. Andrews, 2006.

Multani, Sukhvinder K. Infant and Child Mortality: Issues and Initiatives. Hyderabad, India: ICFAI University Press, 2009.


Partnership for Maternal, Newborn, and Child Health. (accessed November 7, 2010).

UNICEF. “The State of the World's Children 2010.” (accessed November 7, 2010).

William P. Cunningham

  This information is not a tool for self-diagnosis or a substitute for professional care.