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

Mdala, Johnface Fedes (2015-03)

Thesis (MFamMed)--Stellenbosch University, 2015.

Thesis

ENGLISH SUMMARY : Introduction: Many countries, especially from Sub-Saharan Africa, are unlikely to reach the Millennium Development Goal for under-5 mortality reduction by 2015. This study aimed to identify 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%). 69 (55%) perinatal deaths and 42(70%) post-perinatal deaths were potentially avoidable. The modifiable factors were: late presentation to 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 HIV test in pregnant women in third trimester or during breastfeeding, and lack of review of urgent results of critically ill children. Conclusion: A significant number of deaths in children under 5-years of age could be avoided by attention to the modifiable factors identified in this study.

AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.

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