Circumstances of child deaths in Mali and Uganda: a community-based confidential enquiry

The Lancet Global Health
Merlin L WillcoxA Harnden

Abstract

Interventions to reduce child deaths in Africa have often underachieved, causing the Millennium Development Goal targets to be missed. We assessed whether a community enquiry into the circumstances of death could improve intervention effectiveness by identifying local avoidable factors and explaining implementation failures. Deaths of children younger than 5 years were ascertained by community informants in two districts in Mali (762 deaths) and three districts in Uganda (442 deaths) in 2011-15. Deaths were investigated by interviewing parents and health workers. Investigation findings were reviewed by a panel of local health-care workers and community representatives, who formulated recommendations to address avoidable factors and, subsequently, oversaw their implementation. At least one avoidable factor was identified in 97% (95% CI 96-98, 737 of 756) of deaths in children younger than 5 years in Mali and 95% (93-97, 389 of 409) in Uganda. Suboptimal newborn care was a factor in 76% (146 of 194) of neonatal deaths in Mali and 64% (134 of 194) in Uganda. The most frequent avoidable factor in postneonatal deaths was inadequate child protection (mainly child neglect) in Uganda (29%, 63 of 215) and malnutrition in Mali (22%, 124 ...Continue Reading

Citations

Apr 20, 2019·Tropical Medicine & International Health : TM & IH·Jessica PriceAnthony Harnden
Apr 21, 2020·Tropical Medicine & International Health : TM & IH·Andrew Young, Trevor Duke
Mar 27, 2020·The Cochrane Database of Systematic Reviews·Merlin L WillcoxAnthony Harnden
Dec 4, 2019·BMC Public Health·Emma Clarke-DeelderGünther Fink
Jun 25, 2020·Health Policy and Planning·Nicole A PeralesGünther Fink
Apr 19, 2021·Tropical Medicine & International Health : TM & IH·Emily TreleavenJenny Liu
Jun 17, 2021·Revista Panamericana De Salud Pública = Pan American Journal of Public Health·Maylen Liseth Rojas-BoteroFlor de María Cáceres-Manrique
Aug 8, 2021·International Journal of Environmental Research and Public Health·Juliet Mwanga-AmumpaireJoan Nakayaga Kalyango
Sep 26, 2021·British Dental Journal·Noam DinurMichael Solomonov

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