Health systems investments are also required to prevent child mortality. WHO has estimated that 17% of deaths in children younger than 5 years are due to diseases that can be prevented by routine, cost-effective vaccination.16 Although coverage rates of immunisation are high compared with other maternal and child health interventions, many children still die from easily preventable diseases, including pneumonia and diarrhoea.17 New pneumococcal and rotavirus vaccines now exist to prevent these disorders. Coverage can be scaled up by strengthening existing supply chains and by training health workers to provide integrated care at facilities, and through outreach activities to rural communities. Robust health information systems and good management are also needed to ensure efficient and effective immunisation coverage. High rates of malnutrition underlie more than 45% of all deaths in children younger than 5 years and are a significant factor in maternal mortality. For those children who survive, malnutrition jeopardises their potential for optimum growth and development, with important consequences later in life