Non Hospital Deaths .1 Location of Death

59 13.7.2 Personnel Certifying Death Only 40.4 of the non hospital deaths were certified by medical personnel and 71.9 of these were doctors. The majority of non medical personnel certifying non hospital deaths were the police 44.6 followed by staff from the Orang Asli Department 19.6 and family members 16.2. Table 2.12: Under 5 non hospital deaths according to personnel certifying death, Malaysia 2006 Personnel Certifying Death No Medical 160 40.4 Doctors 115 71.9 Medical Assistant 18 11.3 Others Missing 27 16.8 Non Medical 204 51.5 Police 91 44.6 Family 33 16.2 Department of Orang Asli 40 19.6 Religious Head Village Head 8 3.9 Others Missing 32 15.7 Not Available 32 8.1 Total 396 100 13.8 Preventable Deaths 13.8.1 Factors for Preventable Deaths 38.1 of the hospital deaths and 63.4 of the non hospital deaths were thought to be preventable by the attending doctors. The commonest reason for preventable deaths was attributed to patient and family factors 58.0. It was important to note that 19.8 of the preventable deaths were thought to be due to department or treatment problems and 9.4 were thought to be due to peripheral or referral problems. Transport problem was responsible for 12.4 of the deaths and was an important contributing factor in non hospital deaths. 60 Table 2.13: Under 5 deaths by place of death according to whether death was preventable, Malaysia 2006 Was Death Preventable? Hospital Deaths Non Hospital Deaths Total No No No Preventable 496 38.1 251 63.4 747 44.0 Patient family factor 272 54.8 161 64.1 433 58.0 Peripheral or referral centre 57 11.5 13 5.2 70 9.4 Transport problem 27 5.4 66 26.3 93 12.4 Department or treatment problem 126 25.4 22 8.8 148 19.8 Others 10 2.0 21 8.4 31 4.1 Not preventable 552 42.4 59 14.9 611 36.0 Not sure 217 16.7 59 14.9 276 16.2 Not Available 38 2.8 27 6.8 65 3.8 Total 1303 100 396 100 1699 100 13.8.2 Preventable Deaths, Patient and Family Factors The most common patient and family factor that was responsible for preventable hospital and non hospital deaths 53.6 was the care giver was not aware that the child was seriously ill resulting in not seeking care or delay in seeking care. Other reasons given were refusing, defaulting and not complying to care, use of self medication and traditional or complementary medication. 28 home accidents were thought to be preventable. The reason ‘not immunised or missed immunisation’ was given for 29 deaths but there were only 12 deaths from infections preventable by immunisation, 5 from tuberculosis, 3 from measles and 4 from tetanus. Table 2.13a: Under 5 deaths by place of death according to reasons for preventable death due to patient family factor, Malaysia 2006 Hospital Death Non Hospital Death Total Reasons due to Patient Family Factor No No No Unaware of patients illness 153 56.3 79 49.1 232 53.6 Traditional Medicine 10 3.7 5 3.1 15 3.5 Refusal 14 5.1 9 5.6 23 5.3 Poor compliance or defaulted treatment 6 2.2 3 1.9 9 2.1 Not immunised or missed Immunisation 27 9.9 2 1.2 29 6.7 Home accident 9 3.3 19 11.8 28 6.5 Others 50 18.4 43 26.7 93 21.5 Missing 3 1.1 1 0.6 4 0.9 Total 272 100 161 100 433 100