Gates Package — page 941

> of my earliest Yet identifying rotavirus as a chief culprit solved only one of the mysteries of child mortality. The places that experience the highest rates of child mortality are also, not coincidentally, the ones that are least well equipped with diagnostics and other tools that might help them understand what happened. A large share of the deaths happen at home, and not in a hospital where the staff could have recorded the child's symptoms. It has taken dozens of studies to gain an understanding of questions like why children die in their first 30 days of life and what is causing deaths from respiratory illnesses so we can learn how to save those lives. Mozambique is a good example of how the system can work better. Until fairly recently, the government there counted deaths by surveying small parts of the country every few years and then using the data to estimate nationwide mortality. In 2018, though, the country began building what's known as a "sample registration system," which involves continuous surveillance in areas that are representative of the country as a whole. Data from these samples is fed into statistical models that make high-quality estimates about what's going on throughout the nation. For the first time, Mozambique's leaders can see accurate monthly reports on how many people died, how and where they died, and how old they were. Mozambique is also one of several countries that are deepening their understanding of child mortality by participating in a program called the Child Health and Mortality Prevention Surveillance network, or CHAMPS, a global network of public health agencies and other organizations.4 The genesis of CHAMPS dates back nearly two decades to some of my earliest meetings on global health, when I was hearing from experts about the gaps in the field's understanding of why children die. I remember asking, "What do the autopsies reveal?" and being educated on how impractical they are in developing countries. A full autopsy is an