The World Health Report 2005 estimated that 11 million children under five years of age die annually from causes that are largely preventable. Among them are 4 million babies who fail to survive the first month of life. At the same time, more than half a million women die annually in pregnancy, childbirth or soon after. The report says that reducing this toll in line with the Millennium Development Goals depends largely on every mother and every child having the right to access to health care from pregnancy through childbirth, the neonatal period and childhood. For women, human rights include access to services that ensure safe pregnancy and childbirth.

Maternal deaths are now inreasingly rare in developed countries. In many low and middle income countries however, the persistence of high levels of maternal mortality is symptomatic of a pervasive neglect of women's most fundamental human rights. Such neglect affects most acutely the poor, the disadvantaged, and the powerless. For more than half a million women a year, death is the last episode in a long story of pain and suffering; millions more women are left damaged and disabled by childbirth - many of them for the rest of their lives. The suffering often goes beyond the purely physical and affects women's ability to undertake their social and economic responsibilities and to share in the development of their communities. High levels of maternal mortality are not only a "woman's problem". Poor maternal health and its inevitable corollary - poor infant and child health - affect everyone.

Poor prenatal care and malnutrition in mothers have been linked to low birthweight, hearing problems, learning difficulties, spina bifida and brain damage in children. For many babies surviving the neonatal period is a major hurdle and even then the battle to reach adulthood is far from won. Each year more than 10 million children in low-and middle-income countries die before they reach the age of five. The causes of many of these deaths are preventable and include pneumonia, diarrhoea, malaria, measles, and malnutrition. Given this knowledge, an integrated approach to child health that focuses on the well-being of the whole child is advocated. This is known as the Integrated Management of Childhood Illness (IMCI) and has important advantages vis-à-vis a single condition approach. The integrated element ensures attention is paid to all possible causes of sickness including the possibility that a child is infected with HIV. IMCI builds upon the premise that successful care for children needs to be multidimensional, simultaneously fostering children's good health and nutrition and their cognitive, social and emotional abilities. Early childhood care is also a force for positive social change as it has a ripple effect throughout societies.

Introduction by: SCIH, Swiss Tropical Institute (2008)