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Child Fatality Review (CFR) is the process of reviewing all unexpected and unexplained child deaths. The process for conducting a child death review includes:

  • Gathering and presenting information
  • Identifying contributing factors
  • Formulating data-driven recommendations to prevent future child deaths

Each year, approximately 1,600 children die in Ohio. About one-fifth of these deaths are probably preventable. Ohio established a CFR program to better understand how and why our children die and to take action to prevent other child deaths.

The Ohio General Assembly passed Substitute House Bill 448 (HB 448) in July, 2000. On July 6, 2000, Governor Bob Taft signed HB 448, which contains the CFR mandate. The ODH, in consultation with Ohio’s Children’s Trust Fund and CFR boards in existence prior to the effective date of the law, developed rules to assist in the implementation of this law. Following a public and legislative hearing process, the rules became final on June 28, 2001.

Yes. The CFR law mandates each county in Ohio to establish a CFR board. If desired, the boards of two or more counties may create a regional CFR board to serve all participating counties.

For local board contacts, please reach out to the ODH CFR Coordinator.

The CFR law requires the health commissioner who convenes the CFR board to serve on the board as well as the following six required members:

  • County coroner or designee
  • Chief of police or sheriff or designee
  • Executive Director of a public children services agency or designee
  • Public health official or designee
  • Executive director of a board of alcohol, drug addiction and mental health services or designee
  • Physician (pediatric or family medicine)

By April 1 of each year, the local CFR Boards submit a report to ODH that includes:

  • Cause of death
  • Factors contributing to death
  • Demographics
  • Recommendations for actions that might prevent other deaths
  • Number of deaths not reviewed
  • Year of death
  • Geographic location of death

By September 30 of each year, ODH and the Children’s Trust Fund prepare and distribute an annual report to the governor, the speaker of the Ohio House of Representatives, the president of the Ohio Senate, the minority leaders of the Ohio House of Representatives and Ohio Senate, each Ohio county or regional CFR Board and each Ohio county or regional Family and Children First Council as outlined in the CFR law.

CFR boards reviewed the deaths of 1,294 children who died in 2016. Sixty-seven percent (863) of the reviews were for children less than 1 year of age. Most infants died of complications of prematurity, congenital anomalies, sudden infant death syndrome and accidental suffocation.

Of the 1,294 deaths reviewed in 2016, 274 were due to external causes. The leading external causes of death are from vehicular accidents, asphyxia, weapons, and drowning.

For teenagers aged 15-17, intentional injury such as homicide and suicide increase.


Local CFR boards are happy to share what they have learned about the circumstances of child deaths and their recommendations for preventing future deaths. Many boards are seeking community partners to help with prevention initiatives and activities. Visit our Local CFR Boards for contact information, or visit the Links menu for more information.

 The annual Ohio CFR report can be accessed at by clicking here.