Dr. Magdalene Kuria April 2019 Kenya Pediatric Association Conference CHAMPS Overview Dr. Magdalene Kuria April 2019 Kenya Pediatric Association Conference

Reducing Mortality Globally and in Kenya Primary goal of our public health efforts is to reduce mortality BUT, measurement of mortality is limited Need to: Accurately measure trends in mortality overall Know how to measure cause-specific mortality Measure, implement appropriate public health programs, determine impact of those programs, modify as needed

MIA has been identified as one mechanism to obtain better cause-specific mortality surveillance. This paper was published based on early work doing minimally invasive autopsies in Mozambique.

CHAMPS SITES

MIA has been identified as one mechanism to obtain better cause-specific mortality surveillance. This paper was published based on early work doing minimally invasive autopsies in Mozambique.

CHAMPS Catchment Areas and Collaborators CHAMPs sites – Siaya and Kisumu Counties, western Kenya Kisumu: Manyatta Health and Demographic Surveillance System (HDSS) Urban informal settlements in Kisumu city Population - ~61,000 (Baseline survey, 2017) U5MR – 79/1000 (Kenya National Bureau of Statistics) Siaya: Karemo HDSS Rural setting in Siaya County Population – 93,131 (2014) U5MR -99/1000 (HDSS 2014) First CHAMPS case enrolment: 24 May 2017 CHAMPS collaborators in Kenya: US Centers for Disease Control and Prevention Kenya MOH (National and County level) Kenya Medical Research Institute (KEMRI)

Samples Collected

MIA has been identified as one mechanism to obtain better cause-specific mortality surveillance. This paper was published based on early work doing minimally invasive autopsies in Mozambique.

Recruitment and enrolment Flow Transport company invited to carry body to morgue Family members and neighbors accompany the body to the morgue Body immediately stored under refrigeration Hand over medical notes to the pathologist Conduct MITS Agree with the family when to take the body for burial Death notification Eligibility screening Consenting MITs/Non-MITs Release of the body Pre-screening

MIA has been identified as one mechanism to obtain better cause-specific mortality surveillance. This paper was published based on early work doing minimally invasive autopsies in Mozambique.

CHAMPS Data to Action Objective of CHAMPs data-to-action: To generate valued data that can be used by key individual, community, national and global stakeholders for public health decision making Family Health Facility Community National County and Sub-County

Kenya site CHAMPs Data to Action Flow Chart DeCoDe team CHAMPS staff County health departments National gov’t Facility staff Externals partners NGOs, bilateral, multilateral partners More! DeCoDe COD Review of findings Public Health Actions Programming/ Surveillance Updates/ Research Evaluation

Conclusion CHAMPS can inform; Leading cause of deaths and etiological agents highlighting health system failures and patient health-seeking delays CHAMPS Data-to-Action component could be more tightly coordinated with county health departments and health partners Ensure greatest possible impact Dissemination of lessons learned more broadly Improve quality of care Understand rate and causes of death in HIV-exposed but known negative infants