Four delays of child mortality in Rwanda: a mixed methods analysis of verbal social autopsies.
Sanam Roder-DeWanNeil GuptaDaniel M KagaboLameck HabumugishaEvrard NahimanaCatherine MugeniTatien BucyanaLisa R HirschhornPublished in: BMJ open (2019)
Delays in deciding to seek care (phase I) and receiving quality care in FHS (phase III) dominated these narratives; delays in reaching a facility (phase II) were rarely discussed. An unwillingness or inability toadhere to treatment plans after leaving facilities (phase IV) were an important additional delay. Improving quality of care, especially provider capacity to communicate danger signs/treatment plans and promote adherence in the presence of alternative explanatory models informed by traditional medicine, could help prevent childhood deaths.
Keyphrases
- phase ii
- healthcare
- phase iii
- quality improvement
- clinical trial
- palliative care
- open label
- mental health
- health insurance
- affordable care act
- primary care
- double blind
- working memory
- pain management
- adipose tissue
- randomized controlled trial
- placebo controlled
- metabolic syndrome
- combination therapy
- type diabetes
- study protocol
- cardiovascular disease
- chronic pain
- smoking cessation