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An optimist’s approach to improving global child health

Globally, more than six million children die before their fifth birthday each year, most having been born into poverty. While great strides have been made over the last few decades in reducing global child mortality, some countries, like Pakistan, have lagged behind. Today, Pakistan has the third-highest infant mortality rate in the world and some of the worst child health and social indicators in the world.

In a new 1:2:1 podcast, Paul Costello, chief communications officer for the medical school, talks with Anita Zaidi, MD, an internationally renowned pediatrician and director of the Enteric and Diarrheal Diseases Program at the Bill & Melinda Gates Foundation, about the state of child health in her home country of Pakistan and what it takes to lift a nation up. The conversation was adapted from a recent global health seminar sponsored by the Center for Innovation in Global Health.

In speaking to an audience of Stanford students and faculty prior to her talk with Costello, Zaidi described herself as a “relentless optimist” who always takes the “glass half full” perspective. In looking back from 1990 to now, she said Pakistan has made some progress in reducing child mortality, but not as much as what it could have achieved.

Perhaps the biggest barrier to Pakistan’s progress stems from gender inequalities and the poor status of maternal health.

“Women are very marginalized in Pakistan, which affects their health and child mortality,” said Zaidi. “Unless we address those issues, [child health] is a tough problem to take care of… The citizens of Pakistan have a very big role to play.”

In 2013, Zaidi became the inaugural recipient of the $1 million Caplow Children’s Prize for her work in one of Karachi’s poverty stricken fishing communities, Rehri Goth, to save children’s lives. Through her work in Rehri Goth, she saw first hand the complex issues that impact whether a child will live to age five or not. In areas of extreme poverty, like Rehri Goth, improving primary healthcare is not enough.

“There’s no source of income. There are more than 10 kids in a family. Even if their newborn isn’t dying, the child dies at two or three months of age because there’s nothing to eat,” said Zaidi. “You realize there is this sub-population of extremely high-risk individuals, who need more than primary healthcare…They actually need some poverty alleviation types of interventions, food subsidies, to get them out of that.”

So, what does it take to lift a nation up? For Zaidi: “Girls getting educated will change the world, and more and more girls are getting education. We know that [education] one of the strongest predictors of improving child health outcomes."

Rachel Leslie is the communications officer at Stanford’s Center for Innovation in Global Health.

Previously: Pediatric health expert Alan Guttmacher outlines key issues facing children’s health todayCountdown to Childx: Global health expert Gary Darmstadt on improving newborn survival and Training program helps dramatically reduce stillborn rates in developing countries

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