Optimising the use of routine immunisation clinics for early childhood development in sub-Saharan Africa.

There is now ample evidence that factors that account for high infant and child mortality in sub-Saharan Africa and other developing regions are also associated with lifelong developmental impairments in the survivors from early childhood. Of all routine immunisation programmes widely administered soon after birth, bacille Calmette-Guérin (BCG) and diphtheria-pertussis-tetanus (DPT) offer effective platforms to implement a package of interventions that extend beyond child survival to include the early detection and prompt management of developmental disabilities as recently demonstrated in some pilot programmes in sub-Saharan Africa. This paradigm shift is consistent with the Global Immunisation Vision and Strategy (GIVS) of UNICEF/WHO for integrated interventions. It also accords with the current early childhood development policies of all major UN organisations and the World Bank. Such integrated programmes should now be widely encouraged throughout the region by its developmental partners.