Acute Care  |  Discharge  |  Leaving Against Medical Advice  |  Stigma and Wasting

Reducing risk of mortality for sick and malnourished children


The risk of dying during and after childhood illnesses like diarrhoea, pneumonia, overwhelming infection, and malaria is high in low- and middle-incomecountries. The Childhood Acute Illness & Nutrition (“CHAIN”) Network wants to improve the care of children and understand the factors increasing theirchances of dying. The CHAIN study:
- Enrolled children aged 2-23 months who were sick at admission to nine hospitals in four African and two South Asian countries
- Collected information on children’s clinical, nutritional and social situation
- Followed up with children during their hospital stay and for six months after discharge
The CHAIN Study was made possible by the children and their caregivers who voluntarily participated in the study, engagement and support from community members and local Ministries of Health, and the leadership of health workers and researchers from all over the world.

“I met the doctor, and I told him/her to look at my child, and s/he started asking me [in front of every-body], “do you even take the time to feed this child?” I told her/him yes, “then comparing your child with other children, are they of the same size?” Ah, I walked out and came back home.”
Mother – Kenya

“While I was staying in the hospital, my ability to care for my husband and elderly motherin-law were disrupted, and also my rearing of domestic animals [for income]. So, I decided I had to take my child home against the doctor’s advice.”
Mother – Bangladesh

“What could I feel when I have failed to get what I was supposed to give my child? Yes, I will have to give some of his food to his siblings to eat…. honestly speaking right now while I am here getting him checked up, I am not doing any work. So, where will I get that money to buy chicken at fifty shillings for him or fish, when they other siblings need to eat too?”
Mother – Kenya

This is our much waited for boy having already given birth to two girls. Recently, my son was admitted to the hospital twice for his illness. We had to spend a lot of money to cover his treatment. His father sold his agricultural land in our rural home to cover it, and he took an urgent loan from a local NGO. We sacrificed our own foods, sometimes eating less and missing out on other basic needs.”
Mother - Bangladesh


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