The South African child death review pilot: A multiagency approach to strengthen healthcare and protection for children.
BACKGROUND
Child mortality trends in South Africa (SA) show a decrease, but remain high and appear to have plateaued. To attain the new sustainable development goals, we need a better understanding of causes of death and the associated factors.


OBJECTIVE
To describe the SA child death review (CDR) pilot, the pattern of child deaths reviewed and the factors associated with these deaths.


METHODS
CDR teams were established at two pilot sites, Salt River mortuary (Western Cape Province) and Phoenix mortuary (KwaZulu-Natal Province). All child deaths were reviewed by a multidisciplinary team at the pilot sites for the period 1 January 2014 - 31 December 2014.


RESULTS
The CDR pilot reviewed 711 cases. Over half (53.3%) were natural deaths, as opposed to 42.6% non-natural deaths. Most infant deaths (83.9%) were due to natural causes, while 91.7% of deaths in the 15 - 17-year-old age group were due to injuries. The leading cause of deaths reviewed (30.8%) was respiratory tract infection (RTI), mainly among infants (51.6%). Homicide was the second most common cause of death and affected children of all ages, with the highest burden (52.8%) in the 15 - 17-year age group. Child abuse and neglect accounted for 11.3% of deaths. RTI was shown to be more likely after the neonatal period (odds ratio (OR) 2.92; p&lt;0.000) and in preterm infants (OR 1.98; p=0.005).


CONCLUSIONS
CDR teams have been effective in improving identification of the causes of out-of-hospital deaths, as well as by identifying remediable factors critical to reducing child deaths further.
Children's Institute, Faculty of Health Sciences, University of Cape Town, South Africa. shanaaz.mathews@uct.ac.za.
Shanaaz
S
Mathews
Lorna J
LJ
Martin
David
D
Coetzee
Chris
C
Scott
Threnesan
T
Naidoo
Yasheen
Y
Brijmohun
Karisha
K
Quarrie