Improving Child Mortality with a Low-Cost Intervention

Despite reductions in child mortality in recent decades, over 5 million children continue to die every year around the world, with the highest burden in sub-Saharan Africa. Post-hospital mortality is a significant problem in low-income countries, where children can have upwards of a 20% chance of dying following discharge from the hospital. Studies have shown children with chronic diseases are particularly at high risk for death. Responding to the urgent need for post-hospital interventions, Dr. Duncan Hau, Assistant Professor of Pediatrics at Weill Cornell Medicine, Dr. Robert Peck, Associate Professor of Medicine at Weill Cornell Medicine, and colleagues conducted a pilot intervention study that reduced post-hospital mortality rate by 60% for children with sickle cell disease in Tanzania.

Implementing a linkage to care intervention with social workers for children with sickle cell disease, the post-hospital intervention involved 5 sessions of a social worker meeting with children and families over the course of the first 90 days after hospital discharge. These sessions addressed children and families’ barriers to care, assess strengths and resources, and developed a plan to link children and families to outpatient clinics to manage the sickle cell disease. The intervention was able to reduce 12-month post-hospital mortality from 19.2% down to 6.7%, and increase clinic attendance rate from 45.6% up to 93.2%.

The post hospital period is an opportune time to intervene and link children to clinic, and hence reduce overall child mortality. A low-cost social worker intervention can be targeted to children most at risk of dying after discharge in low-income countries.

You can access the full article here: https://pubmed.ncbi.nlm.nih.gov/33516678/

Dr. Duncan Hau in Mwanza, Tanzania