Pediatrics and Child Health

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Browsing Pediatrics and Child Health by Author "Abebe, Hiyaw"

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    Quality Assessment of Facility Based Medical Certification of Cause of Death in the Department of Pediatrics and Child Health at Tikur Anbessa Specialized Hospital Between July-August 2021 Addis Ababa, Ethiopia: A Cross-sectional Study
    (Addis Ababa University, 2021-11) Abebe, Hiyaw; Ahmed, Hayat(MD, Consultant Pediatrician and Fellow Pediatric Cardiologist); Mekonnen, Wubegzier( PhD, Associate Professor of Public Health, School of Public Health)
    Background : As one of the vital events of interest death must always be certified by a person authorized by law to issue a document, stating the causes of death. In order to ensure the universal application of this principle World Health Organization has recommended an international form of medical cause of death certification that is adopted by most countries of the world. A good quality death certificate should fulfill the criteria put forth including a correct documentation of causes of death, with the correct sequence and time intervals. In Ethiopia, however, the internationally recommended death certificate guidelines have not been utilized until now. Objective : The purpose of the study is to assess quality of facility based medical certification of cause of death in the Department of Pediatrics and Child Health at Tikur Anbessa Specialized Hospital. Methods: A hospital based cross-sectional study was conducted with retrospective data collection by reviewing medical death certificates of deceased patients who were admitted at the Department of Pediatrics and Child health before their death. A structured pretested questionnaire with details of the deceased, WHO formatted death certificate and Rapid Assessment Tool were used. Medical death certificates were reviewed by the primary investigator. Errors were identified by the rapid assessment tool and classified as Major and Minor errors. Disparities in the magnitude of errors as compared to age, sex, duration of stay, time of death; qualification of certifier and place of death were assessed. Result: From the 423 reviewed medical death certificates that were reviewed, 100% of them had errors. The commonest major error was a missing time interval between diseases. The commonest minor error was use of abbreviations. Duration of stay of less than 24 hours and certification by a second year resident were associated with a higher chance of error. Death in the Pediatric Intensive Care Unit and Hemato-oncology wards was associated with a lesser incidence of errors. Conclusion: As observed by the percentage of medical death certification errors, this study confirms that there is a high magnitude of error among all of the issued medical death certificates. There is a collectively similar quantity of poor quality certificates regardless of the attributes of the deceased, as well as determinant factors of certifiers. It also demonstrates some of the factors associated with higher or lower proportions of errors. In addition, it has also picked the magnitude of ill-defined Underlying Cause of Death. These are all crucial inputs into hospital and national data.