Child Death Review UP status

1. CHILD DEATH REVIEW
Overview
Prof Dr Sanjev Dave
Community MedicineDept
SMMH Govt. Med.Coll.
Saharanpur
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2. What is Child Death Review?
 Child Death Review (CDR) is a strategy to understand the
geographical variation in causes of child deaths and
thereby initiating specific child health interventions
 Analysis of child deaths provides information about the
-medical causes of death,
-helps to identify the gaps in health service delivery and
--social factors that contribute to child deaths
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3. Key Steps in Child Death Review
 All deaths among children in the age group 0-59
months will be reviewed and reported irrespective of
the place it takes place: at home, in health facility or
in transit
 The details to be investigated will vary in
 neonates (0-28 days) and
 children (29 days-59 months)
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4. Child Death Review will be of two types
 Community Based Child Death Review (CBCDR)
 Facility Based Child Death Review (FBCDR)
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5. CBCDR/FBCDR –Key Steps
Step 1: Notification of child deaths
Step 2: Investigation
Step 3: Data Flow & Analysis
Step 4: Feedback for improved planning and instituting
corrective measures
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6. Child
death
Review:
OPERATIONAl
GUIDElINES
AUGUST
2014
ASHA – Informs about child deaths (0-5 years) to the ANM
and the MOIC within 24 hours of death and fills the notification card within 48 hours
ANM– Conducts the First Brief Investigation within 2 weeks of death of the child and
submits report to the MOIC with in a month
MOIC– Prepares the line list and
selects the cases for detailed
investigation. Copy of the verbal
autopsy form sent to DNO within a
week
Investigators– Conduct the verbal autopsy of cases selected by MOIC and
submit the report to the MOIC
DM– Selected deaths are reviewed monthly in the presence of 2
family members of the deceased Child
CMO– Reviews the child deaths monthly in the DCDRC meeting and minutes sent to SNO
CBCDR Flow Chart
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7. Child
death
Review:
OPERATIONAl
GUIDElINES
AUGUST
2014
DMO– Informs the FNO immediately about the child death in facility and fills the notification
card within 24 hours and conduct the detailed investigation within 48 hours of death
FNO– All Child deaths reviewed by the FBCDR committee every month and
reports sent to the DNO every month
CMO– Reviews the child deaths
monthly in the DCDRC meeting
and minutes sent to SNO
DM– Selected deaths are reviewed monthly in the presence of 2 family
members of the deceased Child
SNO– Prepares the State CDR report for presentation at the State
Level Task Force meeting conducted twice in year
State Level Task Force – Technical & administrative issues re- viewed with clear timelines for action
& further steps
FBCDR Flow Chart
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8. Notification of child deaths
 All deaths occurring in the hospital, Medical
Officer/Specialist on duty at the time of death should fill
in the Notification Card and send it to the office of the
Facility Nodal Officer (FNO) within 24 hours of death
 The office of the FNO (MS/ Principal/ SMO incharge)
should inform the child death to the District Nodal Officer
within 48 hours of the occurrence of death.
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9. Investigation
 The Facility Based Child Death Review (FBCDR) Form
should be filled for each child death by the Duty Medical
Officer
 Medical cause of death is to be ascertained based on SRS
coding for causes of death and recorded in the Death
Certificate
 The completed form should be submitted to the Facility
Nodal Officer within one week of the occurrence of death
in duplicate
 One copy of the form will be sent to the DNO within one
month of death and the second copy retained in the
hospital for records 9

10. Data Flow & Analysis
 FNO will prepare a line list of all child deaths (0-59
months)
 Get data entered using pre-coded Facility Based Child
Death Review format
 District Nodal Officer for information and compilation
in the Format
 key findings and recommendations included in the
report to be presented to District Child Death Review
Committee
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11. District Child Death Review Committee
The Maternal and CDR Committee should be assigned the responsibility of reviewing
Child Death Reports, plus additional members are suggested
1. District Magistrate/District Collector ( Chairperson)
2. Chief Medical Officer (Member Secretary)
3. District Nodal Officer (for Child Death Review )
4. Paediatrician from the district, one or two in number
5. District Project Officer for ICDS
6. Professional bodies –IAP, NNF and IAPSM
7. Expert from medical college/development agency
The Child Death Review meeting should be conducted simultaneously with the Maternal
Death Review, every month
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12. Facility Child Death Review Committee
FBCDR committee may have the following members
• Hospital superintendent
• FNO (Pediatrician)
• Pediatrician/Medical officer Posted in the Pediatrics
• One Anesthesiologist
• Nurse posted in Pediatrics
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13. Selection criteria for cases
• The DNO will be selecting a total of 6 cases (including both CBCDR and FBCDR)
for review at the DCDRC meetings
1. Cause of death
2. Place of death (home, facility, in transit)
3. Age (neonatal, post-neonatal, child)
4. Sex
5. Children from vulnerable groups
6. Clustering of cases (if any)
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14. CDR Meeting
CDR meeting -All FNOs and MOICs should be invited to attend this meeting
• The CDR meeting should be conducted simultaneously with the MDR meeting
• Supposed to take place every month, with the purpose of reviewing the causes
and trends of child deaths in the district
• The Action Taken Reports, the minutes of the last meeting should be reviewed by
the Chairperson.
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15. District Magistrate review meetings of CDR
CMO in consultation with the DNO will select 3 cases (including CBCDR, FBCDR) for
review by the District Magistrate
This review will be attended by the following members:
District Magistrate – Chairperson
Chief Medical Officer
District Nodal Officer
Facility Nodal Officers
IAP representative
Note-DM May also to review more than 3 cases if he chooses to
The parents/relatives (max. 2 persons) of the deceased child would be invited for the
meeting by the DNO
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16. Feedback for improved planning and instituting
corrective measures
• First Brief Investigation reports and the Detailed Investigation should be
reviewed at district level
• Definite actions to address the delays and causes of death should be identified
• The analysis of causes of death will facilitate fine-tuning of programmes locally in
the district
• An Annual Child Death report should be prepared and disseminated to all
stakeholders
• DCDRC discussion on the modifiable factors contributing to child deaths at the
community and facility level
• DCDRC come up with recommendations for short term, medium term and long
term implementation 16

17. Thank you
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