Implementation of Child Death Review in the Netherlands: results of a pilot study

Abstract

BackgroundChild mortality in the Netherlands declined gradually in the past decades. In total 1130 children and youth aged 0 to 19 years died in 2014 (i.e. 29.4 per 100,000 live births). A better understanding of the background and the circumstances surrounding the death of children as well as the manner and cause of death may lead to preventive measures. Child Death Review (CDR) is a method to systematically analyze child deaths by a multidisciplinary team to identify avoidable factors that may have contributed to the death and to give directions for prevention. CDR could be an addition to further reduce avoidable child deaths in the Netherlands. The purpose of this study is to explore the strengths, weaknesses, opportunities and threats (SWOT) of the pilot-implementation of CDR in a Dutch region. The results are translated in recommendations for future implementation of the CDR method in the Netherlands.MethodsChildren who lived in the pilot region and died aged 29 days after birth until 2 years were, after parental consent, included for reviewing by a regional CDR team. Eighteen logs and seven transcribed records of CDR meetings concerning 6 deceased children were analyzed using Atlas ti. The SWOT framework was used to identify important themes.ResultsThe most important strengths identified were the expertise of and cooperation within the CDR team and the available materials. An important weakness was the poor cooperation of some professional groups. The fact that parents and professionals endorse the objective of CDR was an important opportunity. The lack of statutory basis was a threat.ConclusionsMany obstacles need to be taken away before large-scale implementation of CDR in the Netherlands becomes possible. The most important precondition for implementation is the acceptance among professionals and the statutory basis of the CDR method.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1500-9) contains supplementary material, which is available to authorized users.

Barriers, facilitators, and implementation strategies for the initiation of Child Death Review system in Japan: a modified Delphi method study

“…A few previous studies in other countries that have implemented CDR have emphasized on the importance of national legislation of CDR [ 3 , 10 , 28 ]. The International Society for the Prevention of Child Abuse & Neglect reported that CDR is practiced in 42 countries and regions around the world, but there are reportedly many areas that do not have CDR laws [ 5 ].…”

“…The implementation of strategies suggested by CDR may further reduce the number of child deaths. However, various difficulties in applying CDR have been also identified, such as inadequate funding, time intensiveness, the need for committed personnel, difficulty in complete data collection, and lack of legislation [ 3 , 10 , 13 ].…”

Child mortality: preventing future child deaths and optimizing family support

“…To Because analyzing all child deaths appears to be labor-intensive [191] and expensive, one might consider to maintain a kind of stratification with a difference in intensity in analyzing child deaths, starting with for example the categories of child deaths in which the greatest potential for prevention is to be expected or where parents benefit the most. These categories might be deaths due to congenital anomalies, that impacts other children in the family or parents in their decision to have a next child, and sudden and unexpected deaths in children, like SUDI, suicide or unintentional injuries.…”