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This article views the many national and international programs concerned with child survival in developing countries as sharing one important objective, i.e. the exchange of specialized knowledge to mothers who are the primary caretakers of children under age five. If mothers do not possess the knowledge required to develop proper care‐seeking practices, then return on investments in infrastructure, drugs, and human resources development, as these relate to child‐killer diseases such as diarrhea and acute respiratory infection, may not be optimal. Cognizant of reports of the limited impact of health promotion programs, in spite of the investments made, the article models the knowledge exchange process to pinpoint possible sources of problems. Pertinent issues of quality assurance are raised and the consequences of neglecting them pointed out. Some empirical evidence is offered in support of these predicted consequences. Proposes a value analysis framework, to make the point that paying attention to quality assurance concerns is more about optimizing the fit between available resources and ideal outcomes, rather than always being about additional resources.

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