Overcoming remaining barriers : the pathway to survival

Centers for Disease Control have a developed a conceptual framework, the Pathway to Survival, to assist in the development of integrated case management programs for sick children. The Pathway is described and diagramed in this report. Because most care of childhood illness occurs outside of health facilities, caretaker recognition of illness and provision of care are critical components of the Pathway, which is divided into three areas: case management in the home; interface between the home and outside services; and case management outside the home. The Pathway defines key action steps between the onset of illness and a child"s return to health, and highlights events occurring both in the home and in the supporting child health services in the community and health facility. According to the authors, the Pathway forces health planners to think in terms of behavioral and health systems research and interventions, and it is possible that further progress in child survival will be made only by adopting the approach suggested by the Pathway.