The U.N. unveiled a multimillion dollar strategy a dozen years ago to save children worldwide, but a new study has found the program had surprisingly little effect in Bangladesh, one of the world's poorest countries.
Since 1997, more than 100 countries have adopted the Integrated Management of Childhood Illness Program, designed by the World Health Organization and UNICEF. It was supposed to reduce deaths in children under age 5 due to diarrhea, pneumonia, measles and malnutrition, which make up about 70 percent of all child deaths.
Bangladesh is the only country where researchers compared results between areas that implemented the U.N. strategy with those that did not. In research published in the medical journal Lancet on Friday, experts found the program had no major impact on saving children.
U.N. officials could not say how much the program in Bangladesh cost, but said millions have been spent on its implementation around the world.
"It's remarkable the program has achieved so little," said Philip Stevens, a director at the International Policy Network, a London think-tank. "And it's baffling that it has been rolled out globally without any evidence that it works."
The U.N. strategy has three main components: training health workers; improving health systems, which includes ensuring drugs are available; and encouraging communities and parents to do things like maintain good hygiene and have their children immunized.
In Bangladesh, international researchers found the strategy improved the skills of health workers and convinced more people to seek treatment when they got sick. In the areas where the U.N. strategy was used, more children were breast-fed and the prevalence of stunted growth dropped by 20 percent.
But in areas where the program wasn't implemented, slightly more children were vaccinated against measles, and there was no big difference in death rates.
Researchers weren't sure why the program had failed, but said the community part of the U.N. strategy was "less effective than expected."
The study was paid for by the Bill & Melinda Gates Foundation, WHO, and the U.S. Agency for International Development.
Some officials insisted the U.N. needed even more money for the program.
In an accompanying commentary in the Lancet, Trevor Duke of the University of Papua New Guinea called for an extra US$5-8 billion for the program to be expanded in 40 of the world's poorest countries.
Stevens said the U.N. should first prove its strategies work.
"If a private company produced results like this, it would rapidly go out of business," he said. "Yet in U.N. land, failure is used as a justification to ask for more money to do more of the same."
