Related Papers
Piloting a pragmatic clinical audit tool for quality improvement in rural paediatric care in northern Sierra Leone
BOMPOSSEH KAMARA
Hospital admissions and their clinical outcomes can reflect the disease burden in a population and can be utilised as effective surveillance and impact monitoring tools. Inadequate documentation of admissions and their outcomes have contributed to the poor quality of paediatric care in many health care settings in sub-Saharan Africa. We have developed and piloted a simple tool for documentation of basic, standardised patient-level information on causes of admissions, diagnoses, treatments and outcomes in patients admitted to the paediatric ward of a district hospital in a rural community in Sierra Leone.From 1 August 2019 to 31 July 2021, we used this tool to document the admissions, treatments and clinical outcomes of 1,663 children admitted to this hospital. The majority of the children (1015, 62%) were aged between 12-59 months, were boys (942, 57%), were wasted (516, 31%), stunted (238 14%) or underweight (537, 32%). More than half of the children lived more than 1 km distance f...
Archives of Disease in Childhood
Large-scale data reporting of paediatric morbidity and mortality in developing countries: it can be done
2015 •
Adrian Hutchinson
Although the WHO recommends all countries use International Classification of Diseases (ICD)-10 coding for reporting health data, accurate health facility data are rarely available in developing or low and middle income countries. Compliance with ICD-10 is extremely resource intensive, and the lack of real data seriously undermines evidence-based approaches to improving quality of care and to clinical and public health programme management. We developed a simple tool for the collection of accurate admission and outcome data and implemented it in 16 provincial hospitals in Papua New Guinea over 6 years. The programme was low cost and easy to use by ward clerks and nurses. Over 6 years, it gathered data on the causes of 96 998 admissions of children and 7128 deaths. National reports on child morbidity and mortality were produced each year summarising the incidence and mortality rates for 21 common conditions of children and newborns, and the lessons learned for policy and practice. Th...
Archives of disease in childhood
Characteristics of admissions and variations in the use of basic investigations, treatments and outcomes in Kenyan hospitals within a new Clinical Information Network
2015 •
George Ikuta Mbevi
Lack of detailed information about hospital activities, processes and outcomes hampers planning, performance monitoring and improvement in low-income countries (LIC). Clinical networks offer one means to advance methods for data collection and use, informing wider health system development in time, but are rare in LIC. We report baseline data from a new Clinical Information Network (CIN) in Kenya seeking to promote data-informed improvement and learning. Data from 13 hospitals engaged in the Kenyan CIN between April 2014 and March 2015 were captured from medical and laboratory records. We use these data to characterise clinical care and outcomes of hospital admission. Data were available for a total of 30 042 children aged between 2 months and 15 years. Malaria (in five hospitals), pneumonia and diarrhoea/dehydration (all hospitals) accounted for the majority of diagnoses and comorbidity was found in 17 710 (59%) patients. Overall, 1808 deaths (6%) occurred (range per hospital 2.5%-...
BMC Pediatrics
Variation in and risk factors for paediatric inpatient all-cause mortality in a low income setting: data from an emerging clinical information network
2017 •
Samuel Otido
The American Journal of Tropical Medicine and Hygiene
Risk Factors for Mortality in Severely Ill Children Admitted to a Tertiary Referral Hospital in Malawi
2019 •
Chikondi Phiri
American Journal of Internal Medicine
Morbidity and Mortality Statistics in Paediadric Medical Ward of Bingham University Teaching Hospital, Jos
2019 •
alhassan mela
BMJ Global Health
Lessons learned from the development and implementation of an electronic paediatric emergency and acute care database in Lilongwe, Malawi
2020 •
Tisungane Mvalo
As the field of global child health increasingly focuses on inpatient and emergency care, there is broad recognition of the need for comprehensive, accurate data to guide decision-making at both patient and system levels. Limited financial and human resources present barriers to reliable and detailed clinical documentation at hospitals in low-and-middle-income countries (LMICs). Kamuzu Central Hospital (KCH) is a tertiary referral hospital in Malawi where the paediatric ward admits up to 3000 children per month. To improve availability of robust inpatient data, we collaboratively designed an acute care database on behalf of PACHIMAKE, a consortium of Malawi and US-based institutions formed to improve paediatric care at KCH. We assessed the existing health information systems at KCH, reviewed quality care metrics, engaged clinical providers and interviewed local stakeholders who would directly use the database or be involved in its collection. Based on the information gathered, we de...
BMC health services research
Quality of hospital care for sick newborns and severely malnourished children in Kenya: a two-year descriptive study in 8 hospitals
2011 •
Grace Irimu, Aggrey Wasunna, Annah Wamae
Given the high mortality associated with neonatal illnesses and severe malnutrition and the development of packages of interventions that provide similar challenges for service delivery mechanisms we set out to explore how well such services are provided in Kenya. As a sub-component of a larger study we evaluated care during surveys conducted in 8 rural district hospitals using convenience samples of case records. After baseline hospitals received either a full multifaceted intervention (intervention hospitals) or a partial intervention (control hospitals) aimed largely at improving inpatient paediatric care for malaria, pneumonia and diarrhea/dehydration. Additional data were collected to: i) examine the availability of routine information at baseline and their value for morbidity, mortality and quality of care reporting, and ii) compare the care received against national guidelines disseminated to all hospitals. Clinical documentation for neonatal and malnutrition admissions was o...
Annals of Global Health
Demographic and mortality analysis of hospitalized children at a referral hospital in Addis Ababa, Ethiopia
2016 •
Adamu Addissie
Bulletin of the World Health Organization
Management of severely ill children at first-level health facilities in sub-Saharan Africa when referral is difficult
2003 •
Felix Kisanga
To quantify the main reasons for referral of infants and children from first-level health facilities to referral hospitals in sub-Saharan Africa and to determine what further supplies, equipment, and legal empowerment might be needed to manage such children when referral is difficult. In an observational study at first-level health facilities in Uganda, the United Republic of Tanzania, and Niger, over 3-5 months, we prospectively documented the diagnoses and severity of diseases in children using the standardized Integrated Management of Childhood Illness (IMCI) guidelines. We reviewed the facilities for supplies and equipment and examined the legal constraints of health personnel working at these facilities. We studied 7195 children aged 2-59 months, of whom 691 (9.6%) were classified under a severe IMCI classification that required urgent referral to a hospital. Overall, 226 children had general danger signs, 292 had severe pneumonia or very severe disease, 104 were severely dehyd...
