Hedible K. G. B., Anago G. M., Lenaud S., Neboua D., Zair Z., Sawadogo A. G., Louart S., Zombré V., Kaba D. F., Sidibe A., Souleymane H. A., Busière S., Vignon M., Lamontagne F., Ridde Valéry, Leroy V., AIRE Research Study Group. (2025). Challenges and needs before implementing routine pulse oximetry within primary care for sick children in West Africa : baseline assessment within the AIRE project. BMJ Global Health, 10 (Suppl. 8), p. e017298 [12 p.]. ISSN 2059-7908.
Titre du document
Challenges and needs before implementing routine pulse oximetry within primary care for sick children in West Africa : baseline assessment within the AIRE project
Année de publication
2025
Auteurs
Hedible K. G. B., Anago G. M., Lenaud S., Neboua D., Zair Z., Sawadogo A. G., Louart S., Zombré V., Kaba D. F., Sidibe A., Souleymane H. A., Busière S., Vignon M., Lamontagne F., Ridde Valéry, Leroy V., AIRE Research Study Group
Source
BMJ Global Health, 2025,
10 (Suppl. 8), p. e017298 [12 p.] ISSN 2059-7908
Background The Integrated Management of Childhood Illness (IMCI) guidelines are implemented within primary health centres (PHCs) in resource-limited settings. These symptom-based algorithms under-diagnose severe hypoxemia, which contributes to the under-five'mortality in sub-Saharan Africa. To improve the diagnosis and management of severe hypoxaemia, the Améiorer l'Identification des détresses Respiratoires chez l'Enfant (AIRE) project implemented the routine use of pulse oximetry (PO) within IMCI consultations in Burkina Faso, Guinea, Mali and Niger. We described the intervention sites and measured their capacity to offer IMCI care prior to project implementation. Methods A cross-sectional quantitative survey was conducted in all the AIRE PHCs and their district hospitals (DHs) from March to July 2020. Results Overall, 215 PHCs and 8 DHs were surveyed. Almost all the PHCs were public structures, mainly managed by nurses. At least one healthcare worker was IMCI trained in >99% of PHCs. At baseline, PO was available in only 2/215 (1%) PHCs and 4/8 (50%) DH. Median referral rate was estimated to 1.5% per PHC; 35/215 (16%) PHCs had functional ambulances for managing referrals to DHs, including two with mobile oxygen. IMCI consultations were free of fees in Burkina Faso and Niger, but charged for in Guinea and Mali (from US0.5 to US1). All the DHs had capacities to provide specialised paediatric care, although the use of PO was not systematic. Oxygen was available at all DHs except one. Parents of children requiring hospitalisation had to pay out of pocket costs ranging from US1.7 to US8.4 per day. Conclusions This survey highlights the weak adoption of IMCI guidelines in these settings, the absence of PO's at PHC level and their low use at hospital level, as well as difficulties in managing severe cases, referral to hospital and accessing oxygen. It has guided the choice of the AIRE research PHCs and the upgrading of PHCs including IMCI training.
Plan de classement
Santé : aspects socioculturels, économiques et politiques [056]
Description Géographique
BURKINA FASO ; GUINEA ; MALI ; NIGER ; AFRIQUE SUBSAHARIENNE ; AFRIQUE DE L'OUEST
Localisation
Fonds IRD [F B010095831]
Identifiant IRD
fdi:010095831
