Shared principles, local practice: an international survey of child death review systems.

Abstract

Objective: Child death review (CDR) is the multiprofessional review of child deaths aiming to identify causes, risk factors and learning, with the aim of improving services and preventing future deaths.The objective of this study was to determine the range of current CDR practice internationally.

Design: This study used a descriptive comparative survey design to determine similarities and differences between CDR practices in different countries. A secure online questionnaire was developed by the CDR working group of the International Society for the Study and Prevention of Perinatal and Infant Death and distributed via international professional networks.

Setting: Professionals working in CDR in any country globally, contacted via email.

Participants: 27 professionals from 19 different countries participated in the study. To ensure data consistency, duplicate responses from the same region within countries were combined. A total of 20 responses from regions within 13 different countries were included.

Outcomes: Key measures included legal status of CDR systems, family involvement in CDR, legal protection for professionals, multidisciplinary team structure and CDR inclusion criteria.

Results: CDR was identified in 13 countries; 5 describing national CDR programmes and 8 with regional programmes. The aim of all CDR programmes was to prevent future deaths. Laws mandating CDR existed in 15 regions or countries; areas without legislative support reported challenges in conducting CDR. Parental involvement in CDR varied considerably between regions: six required parental consent for reviews, while nine did not inform parents about reviews. In 10 regions, all child deaths regardless of cause were included in CDR, while other programmes reviewed only selected deaths. In seven regions, professionals were provided with legal protection from malpractice claims to enable participation in the CDR.

Conclusions: Common principles underpin effective CDR, providing a foundation for locally adapted approaches to improve systems and prevent future deaths.