Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Community Medicine

Egypt succeeded in gradual declining of the under - five children mortality rate (U5MR). However, the decline in U5MR reached a plateau between 2008 (28 / 1000 live births) and 2014 (27 / 1000 live births). Such situation calls for creative actions beyond using short-term strategies that depend on medical technology for prevention and control of childhood illness. Therefore, "holistic strategic thinking-based on ecological correlation analysis" is required to select the best strategies to reduce U5MR. Identify factors contributing to U5M in Giza districts using ecological correlation analysis; Develop evidence based strategies; Launch district-core team to deliberate strategies for reducing U5MR; Collaborate with the district team to advocate for approved strategy and Follow up achievements in the target strategy at the official level. Giza governorate (21 districts) and intervention and control districts reported the same level of U5MR (13.9 and 13.8 / 1000). The study design was a health system research Intervention study, with exploratory phase (governorate and district levels) and intervention phase in one district. Institute of national planning (Giza districts' output data), Giza Health directorate (service statistics for two districts and staff In-depth interviews), intervention district for FGDs with implementing core team, and site visits to 5 PHC facilities in Intervention district, and 10 facilities in control district to record data using quality checklist that include resources, quality of services and client satisfaction

Issued also as CD