SynthesisJournal of global health2019
Place of death, care-seeking and care pathway progression in the final illnesses of children under five years of age in sub-Saharan Africa: a systematic review.
Synthesis in Journal of global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical Characteristics and Outcomes in Patients with COVID-19 and Cancer: a Systematic Review and Meta-analysis.Clinical oncology (Royal College of Radiologists (Great Britain)) · 2021Pooled it
- Digital payments of health workers within vaccination campaigns: a mixed-methods study in Chad.BMJ global health · 2026Article
- Depression and social support as mediators between coping strategies and quality of life in pulmonary tuberculosis patients.BMC psychology · 2026Article
- Care pathways for critically ill children aged 0-5 years arriving at district hospitals in Burkina Faso, Guinea, Mali, and Niger (2022): a cross-sectional study.BMC public health · 2025Article
- The pathway to child survival in the Birhan Cohort, Ethiopia, 2018-22.Journal of global health · 2025Article
- Mortality in children and adolescents in Western Democratic Republic of Congo: retrospective analysis of verbal autopsy and demographic data from the Kimpese Health and Demographic Surveillance System.BMJ paediatrics open · 2025Article
- Morbidity and unplanned healthcare encounters after hospital discharge among young children in Dar es Salaam, Tanzania and Monrovia, Liberia.BMJ paediatrics open · 2024Observational
- Generalisability of and lessons learned from a mixed-methods study conducted in three low- and middle-income countries to identify care pathways for atrial fibrillation.Global health action · 2023Article
- Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2023Article
- Completeness and Factors Affecting Community Workers' Reporting of Births and Deaths in the Countrywide Mortality Surveillance for Action in Mozambique.The American journal of tropical medicine and hygiene · 2023Article
- Care Seeking and Treatment of Febrile Children with and without Danger Signs of Severe Disease in Northern Uganda: Results from Three Household Surveys (2018-2020).The American journal of tropical medicine and hygiene · 2022Article
- Observational
- Childhood mortality during and after acute illness in Africa and south Asia: a prospective cohort study.The Lancet. Global health · 2022Article
- Refining circumstances of mortality categories (COMCAT): a verbal autopsy model connecting circumstances of deaths with outcomes for public health decision-making.Global health action · 2021Article
- Care-seeking during fatal childhood illness in rural South Africa: a qualitative study.BMJ open · 2021Article
- Letter to the Editor in response to Professor Josef Finsterer.Epilepsy & behavior reports · 2021Article
- Community surveillance and response to maternal and child deaths in low- and middle-income countries: A scoping review.PloS one · 2021Article
- Definitions of Severity in Treatment Seeking Studies of Febrile Illness in Children in Low and Middle Income Countries: A Scoping Review.International journal of public health · 2021Article
- Verbal/social autopsy analysis of causes and determinants of under-5 mortality in Tanzania from 2010 to 2016.Journal of global health · 2020Article
- Care pathways during a child's final illness in rural South Africa: Findings from a social autopsy study.PloS one · 2019Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHalf of all under-5 deaths occur in sub-Saharan Africa. Reducing child mortality requires understanding of the modifiable factors that contribute to death. Social autopsies collect information about place of death, care-seeking and care-provision, but this has not been pooled to learn wider lessons. We therefore undertook a systematic review to collect, evaluate, map, and pool all the available evidence for sub-Saharan Africa.
methodsWe searched PubMed, Embase, Global Health, the Cochrane Library and grey literature for studies relating to under-5 deaths in sub-Saharan Africa with information on place of death and/or care-seeking during a child's final illness. We assessed study quality with a modified Axis tool. We pooled proportions using random effects meta-analysis for place of death and for each stage of the Pathways to Survival framework. Pre-specified subgroup analysis included age group, national income and user-fee policy. We explored heterogeneity with meta-regression. Our protocol was published prospectively (CRD42018111484).
resultsWe included 34 studies from 17 countries. Approximately half of the children died at home, irrespective of age. More children died at home in settings with user-fees (69.1%, 95% confidence interval (CI) = 56.2-80.6, I
conclusionsDespite similar distributions in place of death for neonates and infants and young children, care-seeking behaviour differed by age groups. Poor illness recognition is implicated in neonatal deaths, but death despite care-seeking implies inadequate quality care and referral for older children. Understanding such care-seeking patterns enables targeted interventions to reduce under-5 mortality across the region.
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