Why children die: an under-5 health care survey in Mafikeng region.
OBJECTIVE
To describe causes of under-5 deaths occurring in the health care system in Mafikeng region and modifiable factors related to these deaths.


METHODS
A prospective descriptive study.


METHODS
The four public sector hospitals in Mafikeng health region in North West province (Gelukspan, Zeerust-Lehurutshe, Thusong, and Mafikeng Provincial Hospital).


METHODS
This study of under-5 deaths used and piloted the Under-5 health care Problem Identification Programme.


METHODS
1 November 2000-31 October 2001.


RESULTS
Two hundred and thirty-nine under-5 deaths occurred in the health system. The case fatality rate for the total of 4 226 under-5 admissions was 5.7%. Seventy-four per cent of the under-5 deaths occurred during the first year of life; 31% during the first 24 hours in hospital. The main causes of death were lower respiratory tract infections (31.4%), AIDS (21.3%) and sepsis (13.4%). When adding all causes of death and contributing conditions, 61.9% were AIDS- or HIV-related. Eighty-three per cent of cases had administrative modifiable factors, 67% had modifiable factors at primary care level, 47% during admission/emergency care in hospital, and 55% during routine care.


CONCLUSIONS
Priority problems identified in this study were case management of lower respiratory tract infections, failure to thrive, and insufficient documentation of patient care. As most under-5 deaths in this study were HIV/AIDS-related, it is an urgent necessity to expand effective programmes to prevent mother-to-child transmission and HIV infection in adults and to advocate comprehensive treatment programmes for HIV/AIDS.
Krug
A
A
North West Department of Health, Central Region, Mafikeng.
Pattinson
R C
RC
Power
D J
DJ
D017677:Age Distribution; D002423:Cause of Death; D002662:Child Health Services / Q000592:standards* / Q000706:statistics & numerical data; D002675:Child, Preschool; D015331:Cohort Studies; D003906:Developing Countries; D005260:Female; D017052:Hospital Mortality; D006779:Hospitals, Public / Q000592:standards; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D008297:Male; D008485:Medical Audit; D008499:Medical Records; D011320:Primary Health Care / Q000592:standards; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology