Preventable causes of post-neonatal child deaths in Kakuma refugee camp: verbal autopsies and pathway analysis

The IRC health program in Kenya’s Kakuma Refugee Camp provides primary and secondary health care services at the Kakuma Main hospital and six clinics in the community. The program conducts community outreach activities—including health education and hygiene promotion at the household level—as well as active disease surveillance and immunization services per Kenya expanded program on immunization schedule, and defaulter tracing for ante- and post-natal care. Although health services are widely available and accessible in the camp, mortality rates in children from 1–59 months remains high, with a case fatality rate at the hospital of 28 per 1,000 admissions. The currently available literature provides useful categories for examining vulnerability and health seeking among children under five, but does not tell us much about how to address these issues in long-term refugee populations. This study interviewed family members to document the events leading up to a child’s death (social autopsy method) for 102 child deaths to create a more complete picture of the contributors to post-neonatal under-five mortality. This information was applied to improve service availability and quality in the camp.