PROVIDENCE, R.I. (AP) — Rhode Island child welfare officials say eight children died and 23 nearly died due to neglect or maltreatment over the past two years.

The data released Monday by the state Department of Children, Youth and Families during a meeting of the Rhode Island Children’s Cabinet shows the deaths or near deaths in 2016 and 2017 were due to a variety of factors, including medical neglect, abuse or ingestion of a substance.

Nineteen children were screened by a state agency at birth, and 16 of those screened were determined to be “risk positive,” meaning the child or the child’s mother showed health risks at birth.

The department as well as state public health officials plan to implement new strategies in October, such as better monitoring referrals and holding staff accountable.