By Mirta Roses Periago

mapa americas

image by Mapamundo

The vital importance of the comprehensive development of girls and boys from the very beginning of life has strengthened the alliance between the Pan American Health Organization (PAHO) and the Inter-American Development Bank’s (IDB) Division of Social Protection and Health. That’s why we feel like proud aunts and uncles as we celebrate the first year of First Steps.

The first 1000 days of life or,  in other words, the prenatal period and early childhood, are the best time to invest in children’s development, as evidenced by many research studies, including a longitudinal study by the Institute of Nutrition of Central America and Panama (known as PAHO’s Pan American Center until 2010). This scientific evidence indicates that the benefits of health and nutrition interventions from the very beginning of life, including breastfeeding, mother-child attachment and early stimulation, trickle down as far as the third generation of targeted populations, with better physical, intellectual, cognitive and social interaction indicators.

Decision-makers are aware of these needs and opportunities, which has led to greater public investment in children’s health. The fruits of this investment are evident: between 1990 and 2010, the average mortality rate for children under five in Latin America and the Caribbean fell from 54 to 23 deaths per 1000 live births, an average annual decline of 4.3%. If this trend continues, the region will achieve the Millennium Development Goal (MDG) target of reducing by two thirds the under-five mortality rate by 2015.

But in health, as in education and other areas, major challenges remain for the comprehensive well-being of our children. And so, although the prevalence of acute malnutrition is low, chronic malnutrition remains an unacceptable burden in Latin America and the Caribbean, with nearly nine million children suffering from stunted growth, a condition that severely affects their cognitive capacity and one that’s perpetuated in their descendants. On the other end of the spectrum, obesity in children and teens is a very complex, emerging challenge for public health in the region.

These achievements must therefore serve as encouragement to face the challenges ahead and to tackle new challenges. It’s exactly for that reason that at the 28th Pan American Sanitary Conference in Washington, D.C., the Ministers of Health of the Americas adopted a Strategy and Plan of Action for Integrated Child Health that aims to reduce the burden of disease in children under five and improve their health and nutrition, strengthening the capacity of health institutions and other sectors to work together.

In that context, and together with the initiatives on neonatal health and reduction of maternal mortality, PAHO organizes a Regional Meeting to address the inequalities that affect the reproductive health of women and children. We look to strengthen interventions from health systems and to address social determinants, coordinating the actions of various social, international and government sectors for the integral health of children. The IDB and its  Salud Mesoamérica 2015 Initiative provide strong support and form part of the Partners Steering Committee, together with UNICEF, WFP, USAID, UNFPA, UNAIDS, World Bank and other agencies.

From the first steps and all along the way, the IDB and PAHO will continue to collaborate with each other and with governments, academia and civil society to ensure the comprehensive human development of children in the region.

Dr. Mirta Roses Periago has served as the Director of the Pan American Health Organization since 2003. The First Steps team would like to thank Mirta for writing on her last day as director of PAHO. We wish her success in her new challenges!


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