To counter the high child mortality rate in Moldova, the World Health Organisation (WHO) and the United Nations Children's Fund, UNICEF, have developed a programme to train family doctors, nursing personnel and future parents about the care of small children.

The Republic of Moldova has a relatively child high mortality rate: In 2002, more than 18 children out of every 1,000 did not reach the age of five. The EU average at that time was just under 5 out of every 1,000 children. To combat this problem, UNICEF and WHO have together developed a training programme, known as “Integrated Management of Childhood Illnesses (IMCI)” to train medical personnel who come into regular contact with children, including family doctors, care persons and midwives. The 11-day course teaches them new and simple methods of detecting child illnesses in the early stages and in this way to prevent the development of serious illnesses. The individuals who receive this instruction then teach new or soon-to-be parents about these methods of diagnosis, for which no medical instruments are required. The parents are then able to take preventive action themselves to stop their children developing illnesses, to detect them in the early stages, and even in some cases to treat them.

The project has been discussed and co-ordinated with the Moldovan Health Ministry. The objectives of the project comprise a mix of Millennium Development Goals 4 (reduce mortality rate) and 5 (improve maternal health).

Improved child health and development
The survival and good health of children depends on two main factors:

1. Access to medical care during pregnancy

2. Family care during the pregnancy, nutrition and hygiene, care for sick children and access to treatment by a doctor.

In order to ensure these two factors, it is important to inform the people concerned about the measures they must take and provide the necessary knowledge. By applying the simple principle of information transfer, the SDC and UNICEF together pursue the objective of providing families on an ongoing basis with important information about child health. The knowledge, which is provided by trained medical personnel, can then be put to optimal use by parents. The project, which is co-financed by the SDC, includes the organisation and holding of workshops throughout the Republic of Moldova, the costs of which are split between UNICEF and the SDC. Through this 100% geographical coverage, the aim is to give at least 60% of families with children under five access to important information regarding the care and treatment of children who are ill.

Many beneficiaries
As the project primarily promotes training and access to information that is vital for survival, many people can benefit from it:

1. Small children receive better care and their parents acquire the ability to manage the health of their children more effectively.

2. Medical personnel have the opportunity to receive specialised training in child health.

3. Heads of health authorities in individual districts.

Results
All agreed objectives (reduce child mortality, train medical personnel, disseminate information throughout Moldova) have been achieved, and the child mortality rate has dropped significantly. In 2002, the child mortality rate was 18.4 per thousand; in 2008: 12.1.

The main results are:
1. more than 80,000 children under five and their families have access to better medical care.

2. more that 700 medical personnel (83% family doctors, 17% nursing personnel) are now entitled to offer health and advisory services in child health.

Ten local health experts can use the “train-the-trainers” system to teach medical personnel.