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Abstract Every year, more than 10 million children under five years of age die. Most of those deaths are due to a small number of causes. In the mid 1990s, it was estimated that 70 percent of all global child deaths were due to five conditions: diarrhea, pneumonia, malaria, measles, and malnutrition.A 2003 review covering 42 developing countries, which account for 90 percent of all deaths of children under five years showed the following distribution of causes: neonatal causes constitute 33 % of all deaths followed by 22% due to diarrhea then 21% due to pneumonia while malaria 9 %, AIDS 3%, measles 1 % and other causes 9 %. They tend to occur in the poorest countries of the world, mostly in Sub-Saharan Africa and South Asia, and within any country they affect mostly the poorest families.Until the mid 1990s, actions aimed at improving child health were organized as vertical programs, each addressing a specific disease or providing a given intervention or set of interventions.Typical examples of these programs are the Expanded Program on Immunizations (EPI), Control of Diarrheal Diseases (CDD), acute respiratory infection (ARI) programs, malaria control programs, and nutrition programs that include growth monitoring, breastfeeding promotion and support, and micronutrient supplementation. The realization that a few diseases were responsible for most child deaths, that co morbidity was highly prevalent, that effective interventions were available, and that there were many missed opportunities for prevention led to the recognition that an integrated approach was needed. |