WCH: Child Fatality Review

North Carolina’s Child Fatality Prevention System


The Purpose of the North Carolina Child Fatality Prevention System is to promote understanding of the causes of child deaths, identify deficiencies in the service delivery to children and families by public agencies, and to assess, recommend and implement systems for changes that will prevent future child deaths and support safe and healthy development of our children.


North Carolina’s three-tier child fatality prevention system involves representatives from diverse disciplines and local/state government, including the Office of the Governor and members of the General Assembly. Specific accomplishments over the past 20 years include the following:

  • Infant mortality has declined more than 28 percent. A variety of strategies have contributed to this reduction, including state and local Safe Sleep campaigns, breastfeeding promotion, and 17-Progesterone distribution to reduce recurring preterm births.
  • Reductions in deaths due to unintentional causes have been substantial, largely due to declines in motor vehicle deaths. With the passage of the graduated driver license in North Carolina, driver crashes are down 38 percent for 16 year olds and 20 percent for 17 year olds. Since the requirement for child safety seats, the number of motor vehicle related deaths for children birth through age nine declined more than 25 percent. Additionally, the number of children killed by fire and flame decreased by 44 percent following policies promoting broader use of smoke alarms.
  • The caseloads of Child Protective Services staff have been cut in third, from about 1 worker for every 30 abused and neglected children in 1991 to about 1 worker for every 10 or 11 abused and neglected children today. This lower rate allows staff more time to provide services to vulnerable children to assure that they can grow up in permanent, stable families. Thanks to other improvements in the child welfare system, the rate of children removed from their homes to live with foster families has declined more than 10 percent.

Details on the three-tier system:

Related Information

Community Child Protection Teams

Last Modified: June 18, 2019