Can a system intervention employing team-based case review help improve quality and safety of paediatric hospital care in Kenya?

Six percent of children admitted to Kenyan hospitals die—a death rate many times higher than in wealthy countries. This project tackles the question of whether a structured team-based case review system can reduce those preventable deaths. The problem is that severely ill children often need coordinated care from multiple health workers over several days, which exposes weaknesses in teamwork, communication, and hospital systems. Current approaches rarely diagnose these failures systematically across multiple hospitals. The researcher will first map the specific quality and safety failures that contribute to avoidable deaths in Kenyan county hospitals, then co-design tools for multi-site team-based case review, and finally test whether this intervention reduces the frequency of modifiable errors and potentially avoidable mortality. If successful, this work could provide a scalable, low-cost method for improving hospital care across Africa—not by importing expensive technology, but by changing how teams review and learn from their own cases. The approach targets the quiet infrastructure of hospital safety: the routines, communication patterns, and decision-making processes that determine whether a child receives the right interventions at the right time. This is applied health systems research with immediate potential for saving lives.