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41. Jahrestagung der Gesellschaft für Tropenpädiatrie und Internationale Kindergesundheit

Gesellschaft für Tropenpädiatrie und Internationale Kindergesundheit e. V.

12.05. - 14.05.2023, Bonn

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Developing a low-cost learning health system to support paediatric and neonatal hospital improvement and research in Kenya

Meeting Abstract

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  • presenting/speaker Mike English - KEMRI – Wellcome Research Programme, Nairobi, Kenya; Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, UK
  • Jalemba Aluvaala - KEMRI – Wellcome Research Programme, Nairobi, Kenya; Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, Kenya
  • Jacinta Nzinga - KEMRI – Wellcome Research Programme, Nairobi, Kenya
  • Tim Tuti - KEMRI – Wellcome Research Programme, Nairobi, Kenya
  • Sam Akech - KEMRI – Wellcome Research Programme, Nairobi, Kenya
  • Michuki Maina - KEMRI – Wellcome Research Programme, Nairobi, Kenya
  • Jacquie Oliwa - KEMRI – Wellcome Research Programme, Nairobi, Kenya; Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, Kenya
  • Ambrose Agweyu - KEMRI – Wellcome Research Programme, Nairobi, Kenya
  • Grace Irimu - KEMRI – Wellcome Research Programme, Nairobi, Kenya; Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, Kenya; Kenya Paediatric Research Consortium, Nairobi, Kenya
  • Kenya Clinical Information Network

Gesellschaft für Tropenpädiatrie & Internationale Kindergesundheit. 41. Jahrestagung der Gesellschaft für Tropenpädiatrie und Internationale Kindergesundheit. Bonn, 12.-14.05.2023. Düsseldorf: German Medical Science GMS Publishing House; 2023. Doc23gtpL01

doi: 10.3205/23gtp01, urn:nbn:de:0183-23gtp017

Published: May 10, 2023

© 2023 English et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

We developed with multiple stakeholders including hospital teams a Clinical Information Network (CIN) in Kenya as a form of low-cost learning health system (LHS) focused on paediatric and neonatal. CIN now includes 24 hospitals including the neonatal unit of the national teaching hospital. The CIN first worked to co-design structured paper medical records that participating hospitals were asked to implement themselves. These focused first on standardising clinical admission, discharge and treatment data and later nursing observations. Data from medical records are entered on discharge by records officers into a common data platform. CIN’s aim was to examine important outcomes of hospitalisation at scale, identify and ultimately solve practical problems of service delivery, drive improvements in quality and test interventions. Over a period of 10 years the nature and range of improvement activity, implementation, observational and interventional research has grown. Clinically this has largely focused on common, serious paediatric illnesses such as pneumonia, severe malnutrition, malaria and diarrhoea with dehydration and neonatal illnesses; conditions for which national guidelines and ETAT+ training were previously developed. The challenges encountered adopting simple technologies (pulse oximetry) and more advanced diagnostics (e.g., Xpert MTB/RIF®) have been explored as well as health system problems that directly affect outcomes (e.g., delays in blood transfusion). The CIN is supporting individual and cluster randomsied trials and disease surveillance informing thinking on malaria vaccines and COVID-19. Employing LHS principles has meant engaging front-line workers, clinical managers and national stakeholders throughout. Our experience suggests LHS can be developed in low and middle-income countries and contribute to strengthening of health services and research systems.