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Causes of mortality and associated modifiable health care factors for children (< 5-years) admitted at Onandjokwe Hospital, Namibia.

Mdala JF, Mash R - Afr J Prim Health Care Fam Med (2015)

Bottom Line: Many countries, especially those from sub-Saharan Africa, are unlikely to reach the Millennium Development Goal for under-5 mortality reduction by 2015.This study aimed to identify the causes of mortality and associated modifiable health care factors for under-5 year-old children admitted to Onandjokwe Hospital, Namibia.A significant number of deaths in children under 5-years of age could be avoided by paying attention to the modifiable factors identified in this study.

View Article: PubMed Central - PubMed

Affiliation: Division of Family Medicine and Primary Care, Stellenbosch University. rm@sun.ac.za.

ABSTRACT

Introduction: Many countries, especially those from sub-Saharan Africa, are unlikely to reach the Millennium Development Goal for under-5 mortality reduction by 2015. This study aimed to identify the causes of mortality and associated modifiable health care factors for under-5 year-old children admitted to Onandjokwe Hospital, Namibia.

Method: A descriptive retrospective review of the medical records of all children under five years who died in the hospital for the period of 12 months during 2013, using two different structured questionnaires targeting perinatal deaths and post-perinatal deaths respectively.

Results: The top five causes of 125 perinatal deaths were prematurity 22 (17.6%), birth asphyxia 19 (15.2%), congenital anomalies 16 (12.8%), unknown 13 (10.4%) and abruptio placenta 11 (8.8%). The top five causes of 60 post-perinatal deaths were bacterial pneumonia 21 (35%), gastroenteritis 12 (20%), severe malnutrition 6 (10%), septicaemia 6 (10%), and tuberculosis 4 (6.7%). Sixty-nine (55%) perinatal deaths and 42 (70%) post-perinatal deaths were potentially avoidable. The modifiable factors were: late presentation to a health care facility, antenatal clinics not screening for danger signs, long distance referral, district hospitals not providing emergency obstetric care, poor monitoring of labour and admitted children in the wards, lack of screening for malnutrition, failure to repeat an HIV test in pregnant women in the third trimester or during breastfeeding, and a lack of review of the urgent results of critically ill children.

Conclusion: A significant number of deaths in children under 5-years of age could be avoided by paying attention to the modifiable factors identified in this study.

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Related in: MedlinePlus

The researcher opinion whether the death was avoidable or not avoidable (N = 125).
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Figure 0001: The researcher opinion whether the death was avoidable or not avoidable (N = 125).

Mentions: The research found that 69 (55%) of perinatal deaths might have been avoidable if the process of care had been different and, in 15 (12%) of the deaths the researcher was not sure whether better care or the same care would have helped to avoid the deaths (Figure 1).


Causes of mortality and associated modifiable health care factors for children (< 5-years) admitted at Onandjokwe Hospital, Namibia.

Mdala JF, Mash R - Afr J Prim Health Care Fam Med (2015)

The researcher opinion whether the death was avoidable or not avoidable (N = 125).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4666289&req=5

Figure 0001: The researcher opinion whether the death was avoidable or not avoidable (N = 125).
Mentions: The research found that 69 (55%) of perinatal deaths might have been avoidable if the process of care had been different and, in 15 (12%) of the deaths the researcher was not sure whether better care or the same care would have helped to avoid the deaths (Figure 1).

Bottom Line: Many countries, especially those from sub-Saharan Africa, are unlikely to reach the Millennium Development Goal for under-5 mortality reduction by 2015.This study aimed to identify the causes of mortality and associated modifiable health care factors for under-5 year-old children admitted to Onandjokwe Hospital, Namibia.A significant number of deaths in children under 5-years of age could be avoided by paying attention to the modifiable factors identified in this study.

View Article: PubMed Central - PubMed

Affiliation: Division of Family Medicine and Primary Care, Stellenbosch University. rm@sun.ac.za.

ABSTRACT

Introduction: Many countries, especially those from sub-Saharan Africa, are unlikely to reach the Millennium Development Goal for under-5 mortality reduction by 2015. This study aimed to identify the causes of mortality and associated modifiable health care factors for under-5 year-old children admitted to Onandjokwe Hospital, Namibia.

Method: A descriptive retrospective review of the medical records of all children under five years who died in the hospital for the period of 12 months during 2013, using two different structured questionnaires targeting perinatal deaths and post-perinatal deaths respectively.

Results: The top five causes of 125 perinatal deaths were prematurity 22 (17.6%), birth asphyxia 19 (15.2%), congenital anomalies 16 (12.8%), unknown 13 (10.4%) and abruptio placenta 11 (8.8%). The top five causes of 60 post-perinatal deaths were bacterial pneumonia 21 (35%), gastroenteritis 12 (20%), severe malnutrition 6 (10%), septicaemia 6 (10%), and tuberculosis 4 (6.7%). Sixty-nine (55%) perinatal deaths and 42 (70%) post-perinatal deaths were potentially avoidable. The modifiable factors were: late presentation to a health care facility, antenatal clinics not screening for danger signs, long distance referral, district hospitals not providing emergency obstetric care, poor monitoring of labour and admitted children in the wards, lack of screening for malnutrition, failure to repeat an HIV test in pregnant women in the third trimester or during breastfeeding, and a lack of review of the urgent results of critically ill children.

Conclusion: A significant number of deaths in children under 5-years of age could be avoided by paying attention to the modifiable factors identified in this study.

Show MeSH
Related in: MedlinePlus