Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111399

Maryam Farzanegan, PhD, UNICEF Innocenti Research Centre, Piazza S.S. Annunziata #12, Florence, 50122, Italy, 39 055 2033 353, mfarzanegan@unicef.org

Severe disparities in child mortality, morbidity and malnutrition exist between rich and poor countries and between communities within each country. Even in the poorest countries there are children who benefit from health care and nutrition services. At the same time, there are children who are repeatedly left out. In Indonesia, for example, under 5 mortality is four times higher in the poorest fifth of the population than in the richest fifth. Globally, over 16% of children under five lack adequate nutrition. Guided by human rights-based programming,this presentation will focus on the 10-20% of most marginalized children who slip through the safety nets and are subject to multiple deprivations and at risk of death by preventable diseases. It emanates from on going collaborative work of UNICEF Innocenti Research Centre with UNICEF New York and Field Offices. Objectives are to: 1)Discuss key indicators to be used to identify the most marginalized populations;2)analyze critical factors that contribute to sustainability of programs;3) identify instructive practices with both successful and unsuccessful outcomes and lessons from field experiences; 4) derive implications for policy and practice. Methodology includes literature review, field visits, structured interviews with policy makers, practitioners and researchers. Main recommendations are: Engage in long-term program development and implementation; collect disaggregated data with respect to the most underserved groups; monitor for equity and revise programs accordingly; improve access to basic services by establishing safety nets for the poorest groups; develop infrastructure and support systems; strengthen local capacity by using participatory approaches; and include follow-up plans.

Learning Objectives: