Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada.
Robinson Research Institute and Adelaide Medical School, the University of Adelaide, SA, Australia; Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
Lancet. 2022 May 7;399(10337):1810-1829. doi: 10.1016/S0140-6736(21)02725-2. Epub 2022 Apr 27.
Progress has been made globally in improving the coverage of key maternal, newborn, and early childhood interventions in low-income and middle-income countries, which has contributed to a decrease in child mortality and morbidity. However, inequities remain, and many children and adolescents are still not covered by life-saving and nurturing care interventions, despite their relatively low costs and high cost-effectiveness. This Series paper builds on a large body of work from the past two decades on evidence-based interventions and packages of care for survival, strategies for delivery, and platforms to reach the most vulnerable. We review the current evidence base on the effectiveness of a variety of essential and emerging interventions that can be delivered from before conception until age 20 years to help children and adolescents not only survive into adulthood, but also to grow and develop optimally, support their wellbeing, and help them reach their full developmental potential. Although scaling up evidence-based interventions in children younger than 5 years might have the greatest effect on reducing child mortality rates, we highlight interventions and evidence gaps for school-age children (5-9 years) and the transition from childhood to adolescence (10-19 years), including interventions to support mental health and positive development, and address unintentional injuries, neglected tropical diseases, and non-communicable diseases.
在提高低收入和中等收入国家关键母婴和儿童早期干预措施的覆盖率方面,全球已经取得了进展,这有助于降低儿童死亡率和发病率。然而,不平等仍然存在,尽管许多挽救生命和养育的干预措施成本相对较低,具有很高的成本效益,但许多儿童和青少年仍然没有得到这些干预措施的覆盖。本系列论文以过去二十年关于生存的循证干预措施和护理包、实施策略以及接触最脆弱人群的平台的大量工作为基础。我们审查了目前关于各种基本和新兴干预措施有效性的证据基础,这些干预措施可以从受孕前一直持续到 20 岁,以帮助儿童和青少年不仅能够成年后存活下来,而且能够最佳地成长和发育,支持他们的幸福感,并帮助他们充分发挥他们的发展潜力。虽然扩大 5 岁以下儿童的循证干预措施可能对降低儿童死亡率的效果最大,但我们强调了针对学龄儿童(5-9 岁)和从儿童到青少年过渡时期(10-19 岁)的干预措施和证据差距,包括支持心理健康和积极发展的干预措施,并解决意外伤害、被忽视的热带病和非传染性疾病。