@article{fdi:010095831,
  title = {{C}hallenges and needs before implementing routine pulse oximetry within primary care for sick children in {W}est {A}frica : baseline assessment within the {AIRE} project},
  author = {{H}edible, {K}. {G}. {B}. and {A}nago, {G}. {M}. and {L}enaud, {S}. and {N}eboua, {D}. and {Z}air, {Z}. and {S}awadogo, {A}. {G}. and {L}ouart, {S}. and {Z}ombr{\'e}, {V}. and {K}aba, {D}. {F}. and {S}idibe, {A}. and {S}ouleymane, {H}. {A}. and {B}usi{\`e}re, {S}. and {V}ignon, {M}. and {L}amontagne, {F}. and {R}idde, {V}al{\'e}ry and {L}eroy, {V}. and {AIRE} {R}esearch {S}tudy {G}roup,},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {T}he {I}ntegrated {M}anagement of {C}hildhood {I}llness ({IMCI}) guidelines are implemented within primary health centres ({PHC}s) in resource-limited settings. {T}hese symptom-based algorithms under-diagnose severe hypoxemia, which contributes to the under-five'mortality in sub-{S}aharan {A}frica. {T}o improve the diagnosis and management of severe hypoxaemia, the {A}m{\'e}iorer l'{I}dentification des d{\'e}tresses {R}espiratoires chez l'{E}nfant ({AIRE}) project implemented the routine use of pulse oximetry ({PO}) within {IMCI} consultations in {B}urkina {F}aso, {G}uinea, {M}ali and {N}iger. {W}e described the intervention sites and measured their capacity to offer {IMCI} care prior to project implementation. {M}ethods {A} cross-sectional quantitative survey was conducted in all the {AIRE} {PHC}s and their district hospitals ({DH}s) from {M}arch to {J}uly 2020. {R}esults {O}verall, 215 {PHC}s and 8 {DH}s were surveyed. {A}lmost all the {PHC}s were public structures, mainly managed by nurses. {A}t least one healthcare worker was {IMCI} trained in >99% of {PHC}s. {A}t baseline, {PO} was available in only 2/215 (1%) {PHC}s and 4/8 (50%) {DH}. {M}edian referral rate was estimated to 1.5% per {PHC}; 35/215 (16%) {PHC}s had functional ambulances for managing referrals to {DH}s, including two with mobile oxygen. {IMCI} consultations were free of fees in {B}urkina {F}aso and {N}iger, but charged for in {G}uinea and {M}ali (from {US}$0.5 to {US}$1). {A}ll the {DH}s had capacities to provide specialised paediatric care, although the use of {PO} was not systematic. {O}xygen was available at all {DH}s except one. {P}arents of children requiring hospitalisation had to pay out of pocket costs ranging from {US}$1.7 to {US}$8.4 per day. {C}onclusions {T}his 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. {I}t has guided the choice of the {AIRE} research {PHC}s and the upgrading of {PHC}s including {IMCI} training.},
  keywords = {{H}ealth systems evaluation ; {G}lobal {H}ealth ; {C}hild health ; {H}ealth {S}ervices ; {A}ccessibility ; {C}ross-sectional survey ; {BURKINA} {FASO} ; {GUINEA} ; {MALI} ; {NIGER} ; {AFRIQUE} {SUBSAHARIENNE} ; {AFRIQUE} {DE} {L}'{OUEST}},
  booktitle = {},
  journal = {{BMJ} {G}lobal {H}ealth},
  volume = {10},
  numero = {{S}uppl. 8},
  pages = {e017298 [12 p.]},
  ISSN = {2059-7908},
  year = {2025},
  DOI = {10.1136/bmjgh-2024-017298},
  URL = {https://www.documentation.ird.fr/hor/fdi:010095831},
}