"International child health programmes in low-income countries are justified in term of their impact on child survival. However, the effect estimates are usually calculated from performance indicators and assumptions about efficacy based on small-scale target-specific studies. There is little follow-up of how the programmes are implemented in real life. 

This approach is clearly not sufficient. Recent studies have consistently shown that vaccines and micronutrients have non-specific effects, i.e. effects which are not explained by prevention of the targeted infections or deficiencies. These effects are often sex-differential. Furthermore, interventions may interact. Hence, the overall impact of child health programs can not be extrapolated from small-scale target-specific studies. There is a need to assess the real life impact and cost-effectiveness of child health intervention programmes in the context where they are being used (...)"