Confidential Enquiry into Child Deaths

Investigating how to avoid child deaths in the developing world

10 million children die every year before reaching their fifth birthday, most of them in low-income countries. The medical causes of these deaths are well known, and proven interventions exist to prevent and treat the major illnesses. Often it is not clear why health systems are failing to save lives.

By studying specific cases of deaths in Uganda and Mali, we are seeking to understand what went wrong in each case, and so to identify how such deaths could be avoided. Fieldworkers investigate each death by interviewing the family and any health workers involved, and this information is reviewed by a panel of local health staff every month. The panel identifies avoidable factors and makes recommendations as to how the health system could be improved to save more lives in the future. Some of these recommendations can be (and are) implemented immediately. For example in Mbarara Regional Referral Hospital, a high-risk antenatal clinic has been instituted. We plan to disseminate the results at every level as a way of improving quality of care. We hypothesise that this participatory approach will motivate those responsible to improve the health system, and will help them to prioritise where to target scarce resources.

This study is part of the EU-funded HURAPRIM project (Human Resources in African PRIMary care). 

For more information contact Merlin Willcox or Anthony Harnden.