The document discusses the United Nations Millennium Development Goals and focuses on Goal 4 of reducing child mortality. It provides statistics on child mortality rates globally and in Kenya. It then describes an initiative called Goal4 that aims to reduce under-five mortality in the village of Sega, Kenya through establishing a connected community of health practitioners, increasing access to healthcare knowledge and supplies, and implementing programs like an electronic medical record system, connecting community health workers, expanding local health facilities, launching a telemedicine program, and improving public sanitation. The goal is to address the major causes of under-five deaths in the region through an integrated community health approach.

1. goal4.org
Overview
January, 2012

2. United Nations Millennium Development Goals
(UNMDGs)
Governments and NGOs around the world are working together
to meet these goals
GOAL 1 GOAL 5
Eradicate Extreme Improve Maternal
Poverty and Hunger Health
GOAL 2 GOAL 6
Achieve Universal Combat HIV/AIDS, Malaria
Primary Education and other Diseases
GOAL 3 GOAL 7
Promote Gender Equality Ensure Environmental
and Empower Women Sustainability
GOAL 4 GOAL 8
Reduce Child Mortality Develop a Global Partnership
for Development

3. 2010 United Nations Progress Report on Goal 4
Child deaths are falling,
but not quickly enough to reach the target
• Best progress comes with basic public health and nutrition interventions
(immunization, breastfeeding, vitamin A supplementation, safe drinking water)
• Innovative solutions, such as getting women to deliver in health centers
• Under nutrition is an underlying cause of at least one third of all under-five
deaths
• Increased nutrition interventions such as early and exclusive breastfeeding will
reduce under nutrition, pneumonia, and diarrhea
In Sub-Saharan Africa…
Mortality rate for children under 5 has declined by 28% since 1990
Accounts for nearly half of the 8.1 million under five deaths worldwide
1 in 8 children die before their 5th birthday

4. Sega, Kenya
1. Population 9,000 Sega Village
2. Broadband to the village
3. Nyanza province has highest rate of
under 5 mortality in Kenya
4. Local technical expertise: Cisco
Networking Academy & Sega Silicon
Valley
5. Strong local support from community
leaders and local partners
Nyanza province

5. The Biggest Killers Can Be Counted On One Hand
We know the cause and how to prevent, diagnose and treat
Cause Prevent Diagnose Treat
Pneumonia Vaccine Radiograph Antibiotics
Nutrition/Exclusive Breastfeeding to 6 months Clinical Signs Oxygen
Indoor Air
Diarrheal Safe drinking water Microscope Oral rehydration
Disease Personal hygiene IV rehydration
Public sanitation Zinc
Vaccine Antibiotics
Malaria Insecticide treated bed net Microscope Anti-malarial med
Vaccine (2011)
Malnutrition Exclusive breastfeeding to 6 months Weighing scale Food supplements
Age-appropriate food, sufficient quantity De-worming tablets
Avoid persistent diarrhea, pneumonia, malaria, Check/treat for other
measles diseases: malaria,
Avoid worms via hygiene / regularly de-worm diarrhea, pneumonia
Delivery + 2 Prenatal care & early detection of complications Equipped delivery facility
weeks Prenatal health – supplements, nutrition Delivery kits
Deliver at health center and/or with skilled birth
attendant

6. Situation
Key Indicators Healthcare System
Causes of under 5 deaths: Shortage of staff: from general
support staff to pediatricians
Pneumonia / respiratory infections
Diarrheal diseases Inability to diagnose and
Malaria
treat pediatric cases: lack of
knowledge & supplies
Malnutrition
Lack of medical records: has
Delivery + 2 weeks a child been immunized or not?
* Measles
Lack of prevention: ignorance of
* Mother to Child Transmission AIDS how to prevent, result: overburdened health
system
Rate of under five deaths
(per 1,000 live births):
Lack of trust in health
system
Kenya 85
Nyanza province, Kenya 149 Cost of care
Comparison:
United States 6
Singapore 2

7. Our Goal: Reduce Under-Five Mortality
How?
Build a connected
community of health
practitioners that are
aligned behind
targeting the biggest
killers
A connected, educated, engaged, supplied community – from medical professionals mothers

8. Goal4 Approach
Knowledge, Supplies, Health Marketing
Support the Sega Connected Health
Community by identifying and obtaining
grants / donations of needed supplies
• Medical supplies (meds,
bandages, diagnostic supplies)
• Technical supplies (computers,
smart phones)
• Logistical supplies (bicycles,
bednets, community training tools,
water treatment)
Empowerment via Access to Knowledge Empowerment via Access to Supplies
• Increase Prevention • Support Prevention Programs
• Increase Effective Diagnose & Treatment • Support Effective Diagnosis & Treatment
Support via health marketing and communications campaign

9. Goal4’s Six Programs
Electronic
Medical Record Connected
System & Digital Community
Literacy Health Workers
Telemedicine: Sega Health
Remote Facilities:
Consultation & health delivery
Diagnostics services
Online Pediatric
Health
Community
Public Sanitation
(web portal)

10. Goal4’s Six Programs
Electronic
Electronic
Medical Record
Medical Record Connected
System & Digital Community
System & Digital
Literacy Health Workers
Literacy
Telemedicine: Sega Health
Remote Facilities:
Consultation & health delivery
Diagnostics services
Online Pediatric
Health
Community
Public Sanitation
(web portal)

11. Electronic Medical Record System + Digital Literacy
Sega Cottage Hospital
Sega Mission Hospital
Sega Health Center
EMRS
Hosted at
Sega Silicon
Valley
Matibabu Hospital, Ukwala

12. Goal4’s Six Programs
Electronic
Medical Record
Connected
Connected
System & Digital Community
Community
Literacy Health Workers
Health Workers
Telemedicine: Sega Health
Remote Facilities:
Consultation & health delivery
Diagnostics services
Online Pediatric
Health
Community
Public Sanitation
(web portal)

13. Supporting CHWs
Technical tools for Income generating
managing health opportunities
Training
Home visit kits &
other supplies

14. Sega Digital Health Map
Visual Tool For Managing Health Issues

15. Digital Health Map + EMRS
A Single Health Record Regardless of Source
Sega Cottage Hospital
Sega Mission Hospital
Sega Health Center
EMRS
(Electronic Medical Record
Data Base)
Matibabu Hospital, Ukwala
From CHW home visits From health center visits

16. Mobile Health Tools
Rapidly growing field in developing countries
CellScope
Fetal Weight
Calculates estimated
fetal weight
ARemind
Sends scheduled text
message reminders to
patients

17. Goal4’s Six Programs
Electronic
Medical Record Connected
System & Digital Community
Literacy Health Workers
Sega Health
Telemedicine: Sega Health
Remote
Facilities:
Facilities:
Consultation & healthdelivery
health delivery
Diagnostics services
services
Online Pediatric
Health
Community
Public Sanitation
(web portal)

18. Supporting Sega Health Facilities
• Electricity
• Water
• Maternity facility
• Laboratory
• Income generating opportunities
• Electronic medical records system

19. Supporting Sega Health Facilities
Sega Health Center
Sega Cottage Hospital
Sega Mission Hospital
Matibabu Pediatric Hospital

20. Supporting Sega Health Facilities
Sega Health Center
Sega Cottage Hospital
Sega Mission Hospital
Matibabu Pediatric Hospital

21. Supporting Sega Health Facilities
Sega Health Center
Sega Cottage Hospital
Sega Mission Hospital
Matibabu Pediatric Hospital

22. Supporting Sega Health Facilities
Sega Health Center
Sega Cottage Hospital
Sega Mission Hospital
Matibabu Pediatric
Hospital

23. Goal4’s Six Programs
Electronic
Medical Record Connected
System & Digital Community
Literacy Health Workers
Telemedicine: Sega Health
Remote Facilities:
Consultation & health delivery
Diagnostics services
Online Pediatric
Health
Community Public Sanitation
Public Sanitation
(web portal)

24. Public Sanitation
Clean water source
Latrines with hand washing station &
DFZ (defecation free zones)
Clean indoor air - solar lights
Clean, Safe Light Changes Lives

25. Goal4’s Six Programs
Electronic
Medical Record Connected
System & Digital Community
Literacy Health Workers
Telemedicine: Sega Health
Remote Facilities:
Consultation & health delivery
Diagnostics services
Online Pediatric
Online Pediatric
Health Community
Health
Community
(web portal) Public Sanitation
(web portal)

26. Online Pediatric Health Community
web site / portal
Digital Map

27. Goal4’s Six Programs
Electronic
Medical Record Connected
System & Digital Community
Literacy Health Workers
Telemedicine:
Telemedicine:
Remote Sega Health
Remote Facilities:
Consultation &
Consultation & health delivery
Diagnostics
Diagnostics services
Online Pediatric
Health
Community
Public Sanitation
(web portal)

28. Telemedicine: Remote consultations diagnostics
Local health professionals & Kenya / US health specialists
Dr Bondich, pediatrician,
Eldoret
Nairobi Hosp
Dr A, pediatrician Dr Omoto, OBGYN
Dr B, OBGYN
Sega Cottage Hospital Sample
Sega Mission Hospital
Sega Health Center
Matibabu Hospital
Oakland Children’s
Hospital Kaiser
Dr X, OBGYN Dr X, OBGYN
Dr Y, pediatrician Dr Y, pediatrician

29. Join us on the journey
www.goal4.org/give.html

30. Global Infant & Child Mortality
7.6 million
children died in 2010
21 thousand
children die each day
900
children die every hour

31. Kenya Infant & Child Mortality

32. Impact of Community Health Workers
CHWs provide a critical link
between communities and
health services
Services provided by CHWs
lead to decline in maternal
and child deaths

33. Reports of CHW Impacts
50% improvement
In cases of diarrhea in a Brazilian community
30% improvement
In under 5 mortality in an Indian community