A new study published May in The Lancet on the nine Millennium Villages in Africa shows the under five mortality rate to be declining three times faster in these villages compared to national rural trends.
In the African Millennium Villages, the mortality rate among children under the age of five dropped by 22% in just three years. This equates to a 32% decrease when compared to similar villages not included in the project.
This findings, which showcased project sites in nine sub Saharan African countries, shows that the under five mortality rate (U5MR) is declining three times faster in the villages compared to national rural trends, a pace reliable to achieve Millennium Development Goal (MDG) Four on child health.
The authors attribute the gains to the effectiveness of an integrated multi sector approach to sustainable development, which has helped increase access to basic medical care, skilled deliveries, greater food security and safer water while reducing rates of malaria, diarrhoea, and other preventable diseases.
The results show that communities in the Millennium Villages are on track to achieve the MDGs by 2015 if this progress can be sustained.
The results also demonstrate that despite widespread doubts at the start of the project, integrated and multi sector strategies can be effectively implemented in impoverished settings in rural Africa.
The progress was achieved through an increase in annual development spending per person in the range of US$ 27 to US$ 116, of which about half came from external donors.
The amount is well within internationally agreed levels of Official Development Assistance (ODA), indicating it is possible to build an integrated, multi sector development program at very low costs.
Households within the Millennium Villages project sites were followed between 2006/07 and 2009/10 to measure the effectiveness of interventions in the health sector.
Such interventions included the construction of clinics, the introduction of free basic healthcare, the distribution of bed nets and immunization campaigns. Interventions were also made in agriculture, nutrition, water and sanitation and infrastructure.
These results were then compared to nearby sites that did not follow the project’s multi sector investment approach.
For this 10 year project, indicators suggest that progress has continued after 2009/10 and the deployment of community health workers, according to the study.
“This demonstrates the feasibility of scaling up basic public health delivery in low income settings,” said Jeffrey Sachs, Director of the Earth Institute and Special Advisor to United Nations Secretary General, Ban Ki-moon, who came up with the Millennium Villages idea.
At least one out of every eight children in sub Saharan Africa dies before their fifth birthday. This rate is roughly 15 times higher than the rate in developed economies. Child deaths on the African continent mainly result from diarrhoea, pneumonia, malaria, and HIV infection, all of which are compounded by under nutrition.
These health conditions are linked to weak and under financed health systems, drug shortages, and health clinic user fees, all of which represent critical obstacles to universal coverage.
The nine countries involved in the study were Ghana, Kenya, Malawi, Mali, Nigeria, Rwanda, Senegal, Tanzania and Uganda.