Child Survival Action

“Think of the baby born in Sierra Leone today, does that baby have a voice of its own? The voiceless need to be defended”

– Sierra Leone Minister of Health

Photo of two women holding three young children
Fifty-four countries need accelerated action to reach the under-five mortality target of the Sustainable Development Goals (SDGs): SDG 3.2.1. A “business as usual” approach to planning and implementing health services for children without considering inequities will result in countries not meeting their SDG commitment to end preventable child deaths.

What is Child Survival Action? Our Vision Action Teams Frequently Asked Questions Events Resources

What is Child Survival Action?

At a complementary event to the 75th World Health Assembly in May 2022, Ministers of Health and high level government representatives from seven African countries as well as international development partners agreed there is immediate need for urgent evidence-based action in the 54 targeted countries to tackle the unfinished agenda of child survival, to rally governments and partners for more effective coordination and implementation of policies and investments, both human and financial. Only when children first survive will they be able to thrive and reach their full human potential.

The Child Survival Action (CSA) initiative is a renewed call to all partners—national governments, civic and traditional leaders, communities, and regional and global stakeholders—to end preventable child deaths. The initiative urges partners to join hands to address the programmatic and health system challenges that hamper progress in child survival, especially in countries not on track to meet their 2030 targets. Addressing these barriers will require energizing national and subnational leadership, expanding strategic investments in primary health care (PHC) and multi-sectoral actions, mobilizing partnerships across stakeholders, and aligning funding and other initiatives. The initiative identifies opportunities that exist and lays out the steps that partners need to take to reach all children with life-saving interventions.

Countries needing accelerated action to meet the SDG target

Hover over the country to see its projected 2030 under-five mortality rate, based on the annual rate of reduction presented in the 2022 UN IGME report.

Countries Partnering with CSA

  • Nigeria
  • Sierra Leone
  • South Sudan

Our Vision

The Child Survival Action initiative holds a vision of ending preventable deaths of newborns and children under 5 years of age by 2030, with all countries reducing under-5 mortality to 25 or less deaths per 1,000 live births.

The CSA initiative—

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Focuses on the 54 countries, 42 in Africa, that urgently need accelerated efforts to achieve the SDG3 2030 target on child mortality of 25 deaths or fewer per 1000 live births - reaching this target in all countries will avert at least 10 million under-five deaths by 2030.
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Reaches the children being left behind and at risk from leading killers - pneumonia, diarrhea, and malaria - due to malnutrition, lack of access to quality health services including immunization, unsafe water and sanitation, air pollution, conflict and humanitarian disasters, and other key risks to children’s health and survival.
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Strengthens primary health care in facilities and communities to more effectively prevent, diagnose, and treat these causes of child death, and to promote good health and nutrition for all children.
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Builds effective partnerships between governments, local partners, civil society, private sector, regional and global organizations, as part of renewed commitment to child survival.
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Mobilizes required resources from domestic and international sources and sectors to deliver on this renewed vision for children’s health, nutrition, and survival.

The Child Survival Action working group is coordinated by the Secretariat of the Child Health Task Force and includes representatives from the Global Financing Facility (GFF), Save the Children, United Nations Children’s Fund (UNICEF), United States Agency for International Development (USAID), and World Health Organization (WHO). The group now has three action teams: Country Engagement, Advocacy, and Results Framework/Accountability.

Action Teams

Express interest to join one of the action teams ›

Country Engagement

Countries are at the center of action. Inherent to the approach is alignment of existing plans and programs, adaptation to the local context, intra- and inter-sectoral coordination and collaboration to leverage resources, expertise and lessons learned, documentation and iterative learning, and continuous monitoring and quality improvement, toward reaching national and sub-national targets and goals.

The initiative focuses on countries in the African region that need accelerated actions to reach the SDG target for under-five mortality, particularly those with high mortality in the 1-59 month period. As of March 2023, the initiative is partnering with Nigeria, Sierra Leone and South Sudan. Moving forward, the CSA initiative is prepared to partner with any country in which the government expresses interest and commitment to reducing under-five mortality. The CSA initiative seeks to leverage opportunities in countries such as the revision of child health or RMNCAH-N strategies, investment cases, budget renewals, and other government-led and partner-supported initiatives.

In each country that elects to participate, national-level leadership will ensure child survival is integrated into their child health or RMNCAH-N plan and health sector strategic plan, in collaboration with national- and subnational-level technical and civic leaders. Rather than a new or parallel process, all actions will build on and amplify existing child health plans and operational processes to call the attention of all stakeholders to the continuing high levels of preventable mortality and agreeing on a set of actions to accelerate progress towards meeting the 2030 target. Thus, specific actions will be determined by this national-level process. Global organizations that are part of the initiative will be key actors through existing national and subnational health steering and/or technical working groups to ensure involvement of stakeholders at each level of the system. The key actions, including advocacy and joint tracking of progress, will happen at the national and subnational level. The following graphic shows the CSA initiative model of country engagement:

Graphic showing four steps of CSA initiative model of country engagement
Contact us at if you would like to partner with CSA and/or if you have more information to share about child survival efforts in your country.
First page of CSA Blueprint

Child Survival Action: A Blueprint for Advocacy and Action (PDF, 1.5 MB)

The Blueprint for Advocacy and Action on Child Survival complements the CSA vision document and sets out a coordinated approach to advocacy that sees CSA permeate the highest levels of influence, decision-making, and accountability- both at the national level and globally. It is intended to catalyze new momentum and a renewed movement, finishing the work that we started under the Millennium Development Goals to end preventable child deaths.

Graphic showing 3 principles for advocacy and action that underpin the blueprint
Metrics, Results and Accountability Framework

Theory of Change

Deaths in the 1-59 month period accounted for 2.7 million of 2021’s under-five deaths. Mortality in this age group accounts for a substantial proportion of all under-five deaths in the 54 countries needing accelerated action, greater than 60% in some countries. To accelerate progress toward the SDG 3.2 target, investments must be made to achieve mortality reductions in both the newborn and the 1-59 month periods.

Global and country investment in newborn and maternal health has enabled substantial progress in reducing related mortality and improving health outcomes across the MNCAH continuum of care. However, the lack of attention to children 1-59 months has left a gap that compromises the gains in the earlier life stages and can generate harmful impacts later in life. To invest in a newborn’s survival only for that baby to die of pneumonia at 11 or 24 months is an avoidable tragedy.

The 54 countries that need accelerated action to meet the SDG child survival target by 2030 require urgent support to prevent and treat pneumonia, diarrhea, malaria, undernutrition and other main causes of child mortality. Reported care-seeking rates for pneumonia and rates of treatment with oral rehydration salts (ORS) and zinc remain low in these countries. More information on subnational inequalities in intervention coverage and integrated care for children is needed.

Available data show low levels of coverage of interventions for childhood preventative and curative interventions in the 54 countries that need accelerated action compared to the rest of the world. Notable is the low coverage of basic sanitation, basic drinking water, care seeking for symptoms of pneumonia, and treatment of ORS and zinc for diarrhea. The higher coverage of immunization services- a well-funded vertical program- points to the importance of strengthening PHC as the basic platform to deliver key interventions to promote, prevent and treat childhood illness equitably. Using PHC to integrate services, including multi-sectoral action, can leverage existing and better funded programs, like immunization, to deliver multiple services. At country level, data systems must be strengthened to include data from the private sector in routine national health information systems in order to have the complete picture of coverage of services. Beyond coverage, countries need data on the quality of services to determine effective coverage of interventions.

The Monitoring and Evaluation subgroup of the Child Health Task Force is coordinating the development of a Results and Accountability Framework building on the Theory of Change above to support countries to track child survival indicators, milestones and progress.

Frequently Asked Questions

Who can partner with CSA?

The Child Survival Action initiative is comprised of governments, first and foremost, partnering with academic institutions, private sector entities, implementing organizations (including INGOs, NGOs, CBOs, and FBOs), civil society and advocacy groups, and funders (including bilateral and multilateral donors, private foundations and individuals). The initiative welcomes partners from all sectors, including health, WASH, nutrition/agriculture, clean air, safe and secure environment, child protection, education, and social welfare. To join CSA, email us at

Is there funding available through CSA?

Currently, CSA does not offer funding to countries or organizations. Our advocacy efforts include elevating resource needs to the global community as well as resource mobilization at sub-national, national, and regional levels. The CSA team can offer support to countries to develop advocacy plans to incentivize domestic investments and external funding of national child survival priorities.

How can I get involved at the country level?

Find your country’s child health technical working group (CH-TWG) within the ministry of health and join partner dialogues around child survival. If you work on a project in the country delivering child survival interventions, align with the national child health priorities and other programs or partners targeting the same communities. Support strengthening data systems to identify where the child survival needs are at district and sub-district level and target the children not being reached with routine services. If the CH-TWG needs support to develop a child survival action plan, reach out to with technical assistance requests.


Upcoming Events

Currently, no upcoming events are scheduled.

Past Events

- | Madrid, Spain

2nd Global Forum on Childhood Pneumonia

The 2nd Global Forum on Childhood Pneumonia will build on the momentum for action generated by the first Global Forum in Barcelona in 2020, and pivot political attention from COVID-19 to the specific government actions needed to reduce child pneumonia deaths.

- | Online

Understanding the Drivers of Child Mortality during and after Illness in Africa and Asia

The Child Health Task Force hosted a panel discussion with authors of the Childhood Acute Illness and Nutrition (CHAIN) Network study and partners. The study of 3,100 hospitalized children (2-23 months) across 6 countries – Bangladesh, Burkina Faso, Kenya, Malawi, Pakistan, and Uganda – and found that 48% of children died post-discharge and two-thirds of those died at home.

- | Online

Members' Meeting: Child Survival Action

The Child Health Task Force Secretariat hosted a members' meeting to share progress on the initiative to renew action for child survival. In 2020, preventable causes took the lives of nearly 2.7 million children aged from one month to 5 years.

- | Geneva, Switzerland

Child Survival Action: A roundtable discussion for accelerated progress towards 2030

WHO, UNICEF, USAID, GFF, Save the Children, PMNCH, the Child Health Task Force and the Ministries of Health from Sierra Leone and Tanzania hosted a roundtable to discuss a renewed commitment, investment and action for child survival, especially in the post-newborn, under-five period.

Find the recording, presentation slides, and event summary below.