The Millennium Villages Project was introduced into sub-Saharan African villages in order to co-ordinate improvements amongst multiple sectors, including agriculture, infrastructure, the environment, health, education and business.
Three years after the Project was implemented, a new study by Professor Jeffrey D Sachs and Dr Paul M Pronyk from The Earth Institute at Columbia University in New York, published Online First in The Lancet, shows that the mortality rate of children under the age of 5 years has dropped by a third, in comparison to matched control sites, which proves that it is possible to accelerate the Project’s progress towards the Millennium Development Goals (MDGs) by making improvements across various sectors.
The villages for the Project were selected from various rural areas in nine countries that all had high levels of poverty and malnutrition, with an average of about 35,000 inhabitants per village. At 2006 rates, the yearly cost of intervention per person was projected to be $120 USD. The baseline spending levels with regard to the Millennium Development Goal was an average cost of $27 per head. This increased to $116 by the third year, with $25 of the $116 having been spent on health.
Nine Millennium Village sites reported reductions in poverty, food insecurity, stunting as well as malaria prevalence after 3 years in addition to improved water supply and sanitation and access to numerous mother and child health interventions.
The combined effects of these interventions in Millennium Village sites managed to achieve a 22% lower mortality rate amongst children below the age of 5 years compared to baseline, which is an absolute decrease of 25 less deaths per 1,000 live births, as well as a 32% relative drop compared with matching sites, which means an absolute decrease of 30 less deaths per 1,000 live births.
This translates into a three times faster (7.8%) annual average mortality rate reduction of children below the age of 5 years in Millennium village sites, as compared with the most recent 10-year national trends of 2·6%.
The Millennium Village site annual average reduction in mortality rates was significantly higher compared with the 4.4% average annual reduction needed to achieve MDG4, which is looking to lower child deaths by two thirds from 1990 to 2015.
The researchers declare in a concluding statement:
“Our analysis suggests that the integrated delivery of interventions across many sectors is feasible for a modest cost, that substantial progress towards the MDGs can be achieved in a relatively short 3-year period, and that the combination of interventions can lead to reductions in child mortality at a pace sufficient to achieve MDG4 in areas of rural sub-Saharan Africa.
Although health-sector interventions such as immunization and malaria control were potentially important drivers, efforts outside the health sector – such as agricultural inputs to improve food security and nutrition, interventions to reduce access barriers such as the elimination of user fees and the upgrading of roads, transport, and communication, and basic improvements in water and sanitation – probably contributed to the reported improvement in child survival.”
Dr Grace Malenga, from the Kapanga village in Nkhota-kota, Malawi, a former Director of the Malaria Alert Centre in Blantyre, Malawi, and a consultant pediatrician in the Malawi’s national Queen Elizabeth Central Hospital and Dr Malcolm Molyneux at the Blantyre College of Medicine in Malawi write in an accompanying comment:
“A global opportunity now exists to learn and apply the lessons emerging from the Milliennium Villages. Seizing this opportunity will be the joint responsibility of all of us, including individuals and governments of high-income countries, and villagers and governments in developing countries…It is urgent and crucial that we turn the Millennium Villages project to good purpose. This project can be a catalyst for converting the MDGs from nice ideas into achievable objectives.”
Written By Petra Rattue