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Helping Children Survive

Health system quality improvement program

Improving survival rates of children younger than 5 years old

Helping Children Survive is a health system quality improvement program designed to increase survival of children younger than 5 years.

This program includes a 2-day training that equips participants with skills that can help prevent the need for hospitalization or ensure the child survives and thrives through the referral to higher levels of care.

Community and hospital healthcare providers are trained in skills to recognize and stabilize severely ill children — for example, those in respiratory distress and hypovolemic shock.

The Crisis of Mortality
among children under 5 years

In our world today, more than 5.9 million children don’t reach their fifth birthday.¹ Some 55% die from conditions like acute respiratory infections, diarrhea, and sepsis, which can be prevented or treated with access to simple, affordable interventions.

45 of every 1,000 children in India die before reaching their 5th birthday.²

India bears the highest 5 burden of under-5 deaths worldwide: 20% of all under-5 deaths worldwide occur in India.³

Helping Children Survive
improves childhood survival rates

Our goal: Increase survival rates of children younger than 5 years.

How we achieve it: Improve the quality of care and referral linkages between village clinics and district hospitals.

Who we work with: Front-line healthcare providers (often not
medically trained) who evaluate acutely ill children in rural community clinics or other referring facilities, as well as the physicians and nurses at the receiving hospitals.

How helping children
survive works


First, we listen carefully to understand the unique challenges, including healthcare-worker capability, equipment and supplies, and treatment protocols.


We stay connected to our trainees to learn how they use the knowledge, which enables us to continually refine and focus our training on areas of need or identify policy or supply barriers.


We have adapted the established American Heart Association curriculum and training program called Pediatric Emergency Assessment, Recognition and Stabilization (PEARS) to meet the needs of rural and limited-resource areas of India. Pre- and post-testing ensures we understand trainee progress.


We implement a train-the-trainer approach to develop local instructors and foster ownership and sustainability. The ultimate goal is adoption by local and, eventually, national government.

HSFI can address the crisis
of under-5 mortality

To address the crisis of under-5 mortality, the Heart and Stroke Foundation of India is leveraging more than 90 years of experience from the American Heart Association, a global leader in cardiovascular disease research, science-based treatment guidelines, and advocacy for childhood health.

Together, our organizations train 20 million people each year in lifesaving first aid, CPR, and advanced emergency cardiovascular care skills.

Today, we are extending our knowledge and expertise to  imited-resource communities across India. Together, we can improve care for children in India and build a nation of lifesavers where no child has to die from a treatable illness.

1 Liu L, Oza S, Hogan D, et al. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016;388(10063):3027-3035.

2 Global Health Observatory country views, India statistics summary (2002-present). World Health Organization. http://apps.who.int/gho/data/node.country.country-IND. Last updated: 09/24/18. Accessed October 17, 2018.