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Optimising the impact and cost-effectiveness of child health intervention programmes of vaccines and micronutrients in low-income countries

Objective

International child health programmes in low-income countries are justified in term of their impact on child survival. However, the effect estimates are usually calculated from performance indicators and assumptions about efficacy based on small-scale target-specific studies. There is little follow-up of how the programmes are implemented in real life.

This approach is clearly not sufficient. Recent studies have consistently shown that vaccines and micronutrients have non-specific effects, i.e. effects which are not explained by prevention of the targeted infections or deficiencies. These effects are often sex-differential. Furthermore, interventions may interact. Hence, the overall impact of child health programs can not be extrapolated from small-scale target-specific studies. There is a need to assess the real life impact and cost-effectiveness of child health intervention programmes in the context where they are being used.

We propose to use health and demographic surveillance system (HDSS) sites in Africa to register information routinely on all interventions in childhood, such as all vaccinations, micronutrient supplementation, and de-worming, given at health centres or in campaigns. Using this information we will measure the overall health impact of the child health programs.

The HDSS platform can also be used for testing modifications of the current health programmes. We will test a recent finding from a randomised trial in Guinea-Bissau: providing early measles vaccine at 4.5 and 9 months of age compared with the recommended measles vaccine at age 9 months reduced overall mortality from 4.5 to 36 months of age by astonishing 49%.

The HDSS sites already collect data on mortality, and mortality would be the main outcome, but we also aim to identify other relevant comparable outcome parameters which correlate with mortality and which can be used to assess the overall impact of existing and new interventions.

Call for proposal

FP7-HEALTH-2010-single-stage
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Coordinator

STATENS SERUM INSTITUT
Address
Artillerivej 5
2300 Kobenhavn S
Denmark

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Activity type
Research Organisations
Administrative Contact
Torben Theilmann (Mr.)
EU contribution
€ 347 280

Participants (7)

INSTITUTO NACIONAL DE SAUDE PUBLICA
Guinea-Bissau
EU contribution
€ 929 390
Address
Av. Combatente Da Liberdade Da Patria 100
1004 Bissau Codex

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Activity type
Research Organisations
Administrative Contact
Amabelia Rodrigues (Mrs.)
CENTRE DE RECHERCHE EN SANTE DE NOUNA
Burkina Faso
EU contribution
€ 928 400
Address
Bp 02
13 Nouna

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Activity type
Research Organisations
Administrative Contact
Ali Sie (Dr.)
GHANA HEALTH SERVICE
Ghana
EU contribution
€ 495 300
Address
Catherdral Square Adabraka
NA Accra

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Activity type
Public bodies (excluding Research Organisations and Secondary or Higher Education Establishments)
Administrative Contact
Abraham Hodgson (Dr.)
UNIVERSITATSKLINIKUM HEIDELBERG
Germany
EU contribution
€ 215 000
Address
Im Neuenheimer Feld 672
69120 Heidelberg

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Activity type
Higher or Secondary Education Establishments
Administrative Contact
Maria Schmitt (Ms.)
MEDICAL RESEARCH COUNCIL

Participation ended

United Kingdom
Address
20 Park Crescent
W1B 1AL London

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Activity type
Public bodies (excluding Research Organisations and Secondary or Higher Education Establishments)
Administrative Contact
Katie Louise Flanagan (Dr.)
INDEPTH NETWORK
Ghana
EU contribution
€ 39 600
Address
Mensah Wood Street, East Legon 11
KD Accra

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Activity type
Other
Administrative Contact
Osman Sankoh (Dr.)
RIJKSINSTITUUT VOOR VOLKSGEZONDHEID EN MILIEU
Netherlands
EU contribution
€ 45 000
Address
Antonie Van Leeuwenhoeklaan 9
3721 MA Bilthoven

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Activity type
Research Organisations
Administrative Contact
Rob Riesmeijer (Mr.)