Verbal Autopsies for Out-of-Hospital Infant Deaths in Zambia
Autor: | Benard Ngoma, Rotem Lapidot, Ronke Olowojesiku, Magdalene Mwale, Charles Chimoga, Donald L. Thea, Lawrence Mwananyanda, Christopher J. Gill, Andrew Enslen, Anna Larson Williams, William B. MacLeod, Gertrud Munanjala |
---|---|
Rok vydání: | 2021 |
Předmět: |
Out of hospital
medicine.medical_specialty education.field_of_study Fatal outcome Referral business.industry Population Brought in dead Infant mortality 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Family medicine Pediatrics Perinatology and Child Health Health care medicine business education |
Zdroj: | Pediatrics. 147 |
ISSN: | 1098-4275 0031-4005 |
Popis: | OBJECTIVES: In Zambia, a significant number of infants die in the community. It is hypothesized that delays in care contribute to many of these so-called “brought in dead” infants. METHODS: We analyzed free-text narratives from verbal autopsies, in which families narrate the final series of events leading to each infant’s death. Using the 3-delays model framework and working iteratively to achieve consensus, we coded each narrative using NVivo software to identify, characterize, and quantify the contribution of delays and other factors to the fatal outcome. RESULTS: Verbal autopsies were collected from 230 families of brought in dead infants younger than 6 months of age. As many as 82.8% of infants had 1 or more delays in care. The most-common delay was in the family’s decision to seek care (54.8%), even as severe symptoms were frequently described. Similarly, 27.8% of infants died en route to a health care facility. Delays in receiving adequate care, including infants dying while waiting in line at a clinic or during referral from a clinic to a hospital, occurred in 24.7% of infants. A third of infants had been previously evaluated by a clinician in the days before their death. CONCLUSIONS: Delays in care were the rule rather than the exception in this population of Zambian infants. Accessing care requires families to navigate significant logistic barriers, and balance complex forces in deciding to seek care. Strategies to avoid such delays could save many infants lives. |
Databáze: | OpenAIRE |
Externí odkaz: |