Original Research

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

Johnface F. Mdala, Robert Mash
African Journal of Primary Health Care & Family Medicine | Vol 7, No 1 | a840 | DOI: https://doi.org/10.4102/phcfm.v7i1.840 | © 2015 Johnface F. Mdala, Robert Mash | This work is licensed under CC Attribution 4.0
Submitted: 25 February 2015 | Published: 03 June 2015

About the author(s)

Johnface F. Mdala, Division of Family Medicine and Primary Care, Stellenbosch University, South Africa
Robert Mash, Division of Family Medicine and Primary Care, Stellenbosch University, South Africa


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Abstract

Introduction: Many countries, especially those from sub-Saharan Africa, are unlikely to reach the Millennium Development Goal for under-5 mortality reduction by 2015. This study aimed to identify the causes of mortality and associated modifiable health care factors for under-5year-old children admitted to Onandjokwe Hospital, Namibia.

Method: A descriptive retrospective review of the medical records of all children under fiveyears who died in the hospital for the period of 12 months during 2013, using two differentstructured 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%). Sixty-nine (55%) perinatal deaths and 42 (70%) post-perinatal deaths were potentially avoidable. The modifiable factors were: late presentation to a 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 an HIV test in pregnant women in the third trimesteror during breastfeeding, and a lack of review of the urgent results of critically ill children.

Conclusion: A significant number of deaths in children under 5-years of age could be avoided by paying attention to the modifiable factors identified in this study.


Keywords

Child mortality; Perinatal mortality; Modifiable risk factors; Quality of care; Namibia;

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1. Trends and factors associated with early initiation of breastfeeding in Namibia: analysis of the Demographic and Health Surveys 2000–2013
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