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Features of GAPPD

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GAPPD Global Action Plan Prevention Control Pneumonia Diarrhoea features WHO UNICEF

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GAPPD features interventions protect prevent treat pneumonia diarrhoea

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GAPPD - Integrated Global Action Plan for Prevention and Control of Pneumonia and Diarrhoea

Launched jointly by WHO and UNICEF in 2013, GAPPD was the first global framework to set national mortality targets for pneumonia and diarrhoea - the two leading infectious killers of children under 5.

Core Concept - "PROTECT, PREVENT, TREAT"

GAPPD is built around a three-pillar framework:

1. PROTECT

Interventions that protect children from disease:
  • Exclusive breastfeeding for the first 6 months of life
  • Adequate complementary feeding after 6 months
  • Vitamin A supplementation
  • Reduction of indoor air pollution (clean/safe energy technologies)
  • HIV prevention (virtual elimination of paediatric HIV)

2. PREVENT

Interventions that prevent disease:
  • Immunization - vaccines against pneumonia (PCV, Hib) and diarrhoea (rotavirus vaccine, measles vaccine)
  • Hand washing with soap
  • Safe drinking water and improved sanitation
  • Cotrimoxazole prophylaxis for HIV-positive children

3. TREAT

Ensuring access to appropriate case management:
  • Antibiotics for pneumonia (amoxicillin for non-severe; referral for severe)
  • ORS (oral rehydration salts) for diarrhoea
  • Zinc supplementation for diarrhoea management
  • Appropriate case management through community health workers, facilities, and referral care
  • Therapeutic feeding for severely malnourished children

Goals for 2025

TargetGoal
Pneumonia mortality in under-5s< 3 per 1,000 live births
Diarrhoea mortality in under-5s< 1 per 1,000 live births
Incidence of severe pneumoniaReduce by 75% from 2010 levels
Incidence of severe diarrhoeaReduce by 75% from 2010 levels
Stunting in under-5sReduce by 40% from 2010 levels

Coverage Targets

By end of 2025:
  • 90% full-dose vaccine coverage (with 80% in every district)
  • 90% access to appropriate pneumonia/diarrhoea case management (80% in every district)
  • At least 50% exclusive breastfeeding coverage in first 6 months
  • Virtual elimination of paediatric HIV
By end of 2030:
  • Universal access to basic drinking water in healthcare facilities and homes
  • Universal access to adequate sanitation in healthcare facilities (homes by 2040)
  • Universal access to handwashing facilities (water and soap)
  • Universal access to clean and safe energy technologies

10 Key GAPPD Indicators

As tracked by global progress reports, the 10 indicators span both diseases:
Pneumonia-specific (7): PCV coverage, Hib vaccine coverage, exclusive breastfeeding, care-seeking for pneumonia, antibiotic treatment for pneumonia, household solid fuel use reduction, measles vaccination
Diarrhoea-specific (5): Rotavirus vaccine coverage, ORS use, zinc supplementation, exclusive breastfeeding (shared), access to safe water/sanitation/hygiene

Key Features

  1. Integrated approach - addresses both pneumonia and diarrhoea together, recognizing shared risk factors (malnutrition, indoor pollution, lack of clean water)
  2. Multi-level action - involves parents, communities, community health workers, civil society, private sector, and governments
  3. Complements existing frameworks - MDG 4 (child mortality reduction), MDG 7 (water and sanitation), UN Global Strategy for Women's and Children's Health, Global Vaccine Action Plan
  4. Equity focus - targets the 15 countries bearing >70% of global under-5 deaths
  5. Measurable targets - sets specific, quantifiable coverage and mortality targets for accountability
Source: Park's Textbook of Preventive and Social Medicine (Reference 11, p. 194); WHO/UNICEF GAPPD 2013 (ISBN: 9789241505239)
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