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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2006.088732v1 97/2/240    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Perry, H. Articles by Cayemittes, M. Search for Related Content PubMed PubMed Citation Articles by Perry, H. Articles by Cayemittes, M. Related Collections Quality of Care Adolescent Health Birth Outcomes Mortality

Henry Perry, MD, Warren Berggren, MD, Gretchen Berggren, MD, Duane Dowell, MD, Henri Menager, MD, Erve Bottex, MD, Jean Richard Dortonne, MD, Francois Philippe, MA and Michel Cayemittes, MD

Henry Perry is with Future Generations, Franklin, West Virginia. Warren Berggren and Gretchen Berggren are independent international public health advisors based in Golden, Colo. Duane Dowell is retired from Hôpital Albert Schweitzer, Deschapelles, Haiti. Henri Menager is with the Kansas Department of Health and Environment, Topeka. Erve Bottex is with Columbia University, Harlem Hospital Center, Division of Medicine/Infectious Diseases, New York, NY. Jean Richard Dortonne is with the University of Montreal, Montreal, Canada. Francois Philippe is a private consultant in New York City. Michel Cayemittes is with the Institut Haïtien de l’Enfance, Haiti.

Correspondence: Requests for reprints should be sent to Henry Perry, Future Generations, HC 73, Box 100, Franklin WV 26807 (e-mail: henry{at}future.org).

Objectives. Evidence regarding the long-term impact of health and other community development programs on under-5 mortality (the risk of death from birth until the fifth birthday) is limited. We compared mortality in a population served by health and other community development programs at the Hôpital Albert Schweitzer (HAS) with national mortality rates among children younger than 5 years for Haiti between 1958 and 1999.

Methods. We collected information on births and deaths in the HAS service area between 1995 and 1999 and assembled previously published under-5 mortality rates at HAS. Published national rates for Haiti served as a comparison.

Results. In the early 1970s, the under-5 mortality rate at HAS declined to a level three fourths lower than that in Haiti nationwide. More recently, HAS rates have remained at one half those for Haiti nationwide. Child survival interventions in the HAS service area were substantially higher than in Haiti nationwide although socioeconomic characteristics and levels of childhood malnutrition were similar in both areas.

Conclusions. HAS’s programs have been responsible for long-term sustained reduction in mortality among children aged less than 5 years. Integrated systems for health and other community development programs could be an effective strategy for achieving the United Nations Millennium Goal to reduce under-5 mortality two thirds by 2015.

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