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The reduction in mortality in children younger than 5 years over recent decades has been impressive, but shortfalls still exist in achievement of the MDG4 targets.1 Acceleration of progress for child survival would need increased emphasis on quality care at and around birth, and timely and effi cacious treatment for neonatal infections, diarrhoea, and pneumonia in regions where these causes contribute substantially to mortality in children younger than 5 years. The challenge in provision of standard care is increased wherever health systems are weak, socioeconomic conditions are suboptimum, and settings are remote and inaccessible. Innovative implementation research is being widely promoted to provide solutions that improve equitable delivery of established interventions without compromising safety or eff ectiveness. This type of research is challenging and often complex.

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