A community-centred, collaborative, health system strengthening approach to reducing the preventable mortality associated with CAH by 30% by 2030

Children living with congenital adrenal hyperplasia (CAH) and other non-communicable diseases (NCDs) in lower-income countries experience an inequitable burden of preventable mortality and morbidity when compared to those living in higher-income countries. The scale of this inequity and practical solutions to redress it need to be clearly articulated, so that as many individuals and organisations as possible might be engaged in collaborative efforts to drive change. Increased multi-stakeholder and multi-sectoral collaborative initiatives will drive the transformation needed and create an irreversible momentum of change. This review analyses the current situation and uses an adapted version of the WHO’s Six Building Blocks for strengthening health systems to present an evidence-based approach to practical actions that can help reduce the preventable mortality associated with CAH in lower-income countries and globally. Improving access to essential medicines, strengthening CAH communities and scaling newborn bloodspot screening are key objectives. Informational resources, tools and indicators identified in the review with potential to support urgent and collective action, evaluation and monitoring have been collated into a novel Toolkit that is available as a living resource for the @MATES4Kids (Maximising Access To Essential Medicines for Children) Coalition. It is intended this review – and the @MATES4Kids Toolkit – will support efforts not just for children living with CAH in resource-limited settings, but ultimately those affected by other childhood NCDs and chronic conditions as well.