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Adam Wagstaff, DPhil, Flavia Bustreo, MD, MPH, Jennifer Bryce, EdD, Mariam Claeson, MD, MPH and the Who–World Bank Child Health and Poverty Working Group

Adam Wagstaff, Flavia Bustreo, and Mariam Claeson are with Health, Nutrition and Population, World Bank, Washington, DC. Flavia Bustreo is also with, and at the time of writing Jennifer Bryce was with, the Department of Child and Adolescent Health and Development, World Health Organization Geneva, Switzerland.

Correspondence: Requests for reprints should be sent to Flavia Bustreo, MD, MPH, The World Bank, 1818 H St NW, Washington, DC 20433 (e-mail: fbustreo{at}worldbank.org).

In most countries, rates of mortality and malnutrition among children continue to decline, but large inequalities between poor and better-off children exist, both between and within countries. These inequalities, which appear to be widening, call into question the strategies for child mortality reduction relied upon to date.

We review (1) what is known about the causes of socioeconomic inequalities in child health and where programs aimed at reducing inequalities may be most effectively focused and (2) what is known about the success of actual programs in narrowing these inequalities.

We end with lessons learned: the need for better evidence, but most of all for a new approach to improving the health of all children that is evidence based, broad, and multifaceted.

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