title: [Intra-hospital mortality of children in central Africa: looking at the impact of a training programme and increased supervision].
abstract: The study's aim was to evaluate the impact of an in-service training course and supervision of physicians and nurses in terms of quality of care on intra-hospital mortality. The study included 2 cohorts of children. Cohort 1 included 414 children from 0 to 15-years-old who were followed in the paediatric wards of the provincial hospital of Goma (HPG) between April 1, 2003 and March 31, 2004. Cohort 2 included 996 children from 0 to 15-years-old where were treated and followed in the same service between January 1, 2005 and December 31, 2005. General and specific mortalities occurring before and after an intervention were compared, as were the ratios of the observed deaths to the predicted deaths through the application of the Goma1 model to cohort 2. Overall mortality decreased by 15,9% (before the intervention) to 4,6% (after the intervention), translating to a total reduction of 71,1%. The ratios between the observed deaths and the predicted deaths were lower than 1, globally and when stratified. The risk of death in the cohort 1 (before the intervention) is 6,8 times higher than in cohort 2 (after the intervention). This shows an improvement of child survival after the intervention.
authors.affiliation: Faculté de médecine de l'Université de Goma (RDC).
authors.forename: Richard
authors.initials: R
authors.lastname: Bitwe
authors.forename: Carole
authors.initials: C
authors.lastname: Schirvel
authors.forename: Michèle
authors.initials: M
authors.lastname: Dramaix
authors.forename: Philippe
authors.initials: P
authors.lastname: Hennart
mesh_terms: D000293:Adolescent; D000350:Africa, Central; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006776:Hospitals, Pediatric / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007318:Inservice Training; D009934:Organization and Administration / Q000592:standards; D011787:Quality of Health Care; D013997:Time Factors