EVALUATION OF THE CAUSES OF MORTALITY IN CHILDREN UNDER FIVE YEARS AT KISUMU COUNTY REFERRAL HOSPITAL, KISUMU COUNTY

Abstract

Child mortality particularly those under the age of five remains a critical global health concern. According to the World Health Organization in 2020, approximately 5.0 million deaths of children under five years was recorded. In Africa, the under-five mortality is approximately 58%. In Kenya, the under-five mortality is currently at 41.1 deaths per 1000 live births according to United Nations International Children’s Fund as of 2022. Kisumu County recorded 45 deaths per 1000 live births. This shows a higher prevalence at the county level than the country level thus raising a concern. This study provides a comprehensive evaluation of the causes of mortality in children under five years at Kisumu County Referral Hospital in pediatrics ward, newborn unit and MCH. The research employed a retrospective analysis of medical records over a five-year period, complemented by structured interviews with healthcare providers. The study population consisted of all children under the age of five who were admitted to Kisumu County Referral Hospital and subsequently died during the study period. The sampling method employed a convenience sampling technique and the Yamane Taro formula was used for sample size determination. The sample size was 80 individuals. The letter of authority was obtained from the Institutional Review Board of Kisumu County Referral Hospital. The findings revealed that infectious diseases including malaria, pneumonia and diarrhea were the predominant causes of death, exacerbated by underlying conditions such as malnutrition and delayed access to healthcare. The leading cause of death in infectious diseases was diarrhea which was 44%, followed by pneumonia which recorded 29%, malnutrition by 20% and other infectious diseases at 7%. In birth complications the respiratory distress accounted for 38% of mortalities, infections by 12%, low birthweight accounted for 25% of deaths and jaundice for 25%. This study emphasizes on prioritizing prevention of infectious diseases through vaccination campaigns, improved sanitation and the promotion of hygiene practices. Nutrition programs targeting young children and pregnant mothers should be expanded, maternal and newborn health services should be strengthened by increasing access to comprehensive prenatal and postnatal care and ensuring that mothers receive timely and adequate healthcare during pregnancy, labor and after delivery.