Abstract : Accurate data on the causes of death in children under the age of 5-years in Ghana are limited and usually from vital registrations and occasional clinical studies. The aim of this study was to identify and group the underlying causes of death in these children and offer recommendation. Material and methods. This was a retrospective autopsy study from January 2002 to December 2012. Results. Approximately 5.0% of all autopsies performed during the study period were children under the ages of five years. The underlying causes of death were: infections (49.4%), injuries and poisons (20.1%), congenital and developmental abnormalities (17.5%), nutritional (5.3%), neoplasms (2.5%) and haemoglobinopathies (1.8%). Approximately 73.0% of the deaths were preventable. Majority (84.6%) of the deaths occurred in the community and in males (57.2%). Neoplasms related deaths commonly occurred in health facilities. Congenital and developmental abnormities deaths were commoner in neonates. Common infection related deaths were: malaria (37.7%), pneumonia (29.4%) and diarrhoea diseases (21.3%). For injuries and poisons; these were: burns (28.6%); road traffic accidents (26.7%) and drowning (21.5%). Malnutrition was the commonest nutritional cause of death, while lymphomas were the common neoplastic causes of death. Conclusion. Under five deaths were commoner in the community, boys and in the childhood period. Approximately 73.0% of these deaths could have been prevented, by paying attention to the immediate environment of children and use of appropriate medical interventions. We recommend that autopsy data on under five deaths be part of the routine health sector mortality data in Ghana.

Keyword : Ghana, under five, underlying, causes, deaths, autopsy

Abstract : Antenatal care (ANC visits) utilization and skilled birth attendance during delivery are found to be low in developing countries, more so the rural communities of Ghana. The aim of this study was to determine the proportion of pregnant women (PW) who had prenatal care (ANC visits) with the number who had skilled birth attendance during labour in at the West Gonja District of the Northern region of Ghana. This was a cross-sectional descriptive study involving 110 postpartum women (PPW) from 6 health facilities selected through purposive sampling. Data was entered and analysed using SPSS software version 23 (Chicago). The mean age of the PPW interviewed was 28.9 years (SD=6.0) and all were married. The great majority (83.6%) did not have any formal education and approximately, 41.8% were traders. Majority (86.4%) of the postpartum women initiated ANC for their last delivery in the second trimester and that 94.0% had 3 – 4 visits before labour. The majority (76.4%) of the PPW had their last deliveries in a health facility and were all attended to by skilled birth attendant (100.0%). Only 8 (7.2%) out of the 110 PPW had their deliveries by a traditional birth attendants (TBAs). Of this number, 4 (50.0%) had no reason for delivering at the TBA, 3 (37.5%) said there was no health facility in their community, however, 1 (12.5%) said she did not have complications during her last delivery by a TBA. The study found that ANC care services were well-patronized in the West Gonja District by the women. Approximately 76.4% of the women had their last deliveries in a health facility and were all attended to by skilled birth attendant, only 7.2% were attended to by TBAs.

Keyword : Antenatal care, postpartum women, Skill birth attendant, traditional birth attendant, West Gonja, Ghana.