In 1988, Franklin County Children Services in Columbus, Ohio, initiated the development of a community-based, multidisciplinary process to review all deaths of children on its open caseload, and deaths in cases in which the agency had contact with the child or the child's family in the 12 months preceding the child's death. The review process enables the community to identify problems in the service delivery system that are related to child deaths, and to eliminate preventable deaths by enhancing the quality of services and programs. The process also identifies and tracks causal trends in deaths of children. During 1989, 1990, and 1991, the largest proportion of children died as a result of perinatal conditions or congenital defects. The 1990 infant mortality rate for Franklin County was 10.8 deaths per 1,000 live births, with the rate significantly higher for black infants. The percentage of women receiving delayed prenatal care increased between 1988 and 1989, with black women more than twice as likely than white women to receive late prenatal care. Many areas targeted for action in 1992 involved increasing the availability of prenatal care and promoting public awareness of its importance. Key program changes and accomplishments have included revised investigatory policies; in-service training for all staff related to child death risk factors; an increase in staffing and services of various units; and a variety of collaborative activities and revised protocols and practices. An infant service delivery protocol is appended. (AC)