Child survival programs in Egypt

This report evaluates the performance and health impacts of the two programs. Both programs have had high levels of success. ORT awareness and use has spread throughout Egypt and child nutrition during diarrheal episodes has improved. Statistics suggest that an accelerated decline in infant and child mortality in the mid-1980's is essentially the result of the program, especially of its popularization of home and private rehydration. However, the actual incidence of diarrheal episodes has probably not changed, indicating that the program's preventive aspects, ranging from promotion of hygiene among mothers to massive investments in potable water and sewage systems, have yet to prove effective. The EPI program has resulted in rapidly increasing and high coverage rates among childen for all antigens. Although reliable data are not available, EPI has most likely reduced both mortality and morbidity, since unvaccinated Egyptian children are at significant risk from the targeted diseases. On the negative side, coverage rates for tetanus toxoid injections of pregnant women have lagged considerably in comparison with the rest of the program. The rapid success of the two programs is largely due to Egypt's unique positive circumstances: the population's cultural and linguistic homogeneity and concentration along the Nile; extensive health infrastructure and large pool of trained health personnel; availability of low-cost ORT and immunization technologies; and wide access to television. While these factors limit the programs' replicability elsewhere, the programs' flexibility, limited focus, and use of mass media are broadly applicable. Partly because of the success of the two programs, the patterns of infant and child mortality are shifting in Egypt, with acute respiratory infection now emerging as the leading cause of death and hence the main concern of future child survival efforts.