Evaluation of the routine implementation of pulse oximeters into integrated management of childhood illness (IMCI) guidelines at primary health care level in West Africa: the AIRE mixed-methods research protocol.

Autor: Hedible GB; Inserm, University Paul Sabatier Toulouse 3, CERPOP, UMR 1295, Toulouse, France., Louart S; ALIMA, Dakar, Senegal.; IRD, CEPED, Paris, France.; University of Lille, CLERSE - Centre Lillois d'Études et de Recherches Sociologiques et Économiques, Lille, France., Neboua D; ALIMA, Dakar, Senegal., Catala L; Inserm, University Paul Sabatier Toulouse 3, CERPOP, UMR 1295, Toulouse, France., Anago G; ALIMA, Dakar, Senegal., Sawadogo AG; Terre des hommes-Lausanne (Tdh), Ouagadougou, Burkina Faso., Kargougou GD; ALIMA, Bamako, Mali., Meda B; SOLTHIS, Niamey, Niger., Kolié JS; ALIMA, Conakry, Guinea., Hema A; Terre des hommes-Lausanne (Tdh), Ouagadougou, Burkina Faso., Keita S; ALIMA, Bamako, Mali., Niome M; SOLTHIS, Niamey, Niger., Savadogo AS; ALIMA, Conakry, Guinea., Peters-Bokol L; Inserm, University Paul Sabatier Toulouse 3, CERPOP, UMR 1295, Toulouse, France., Agbeci H; Inserm, University Paul Sabatier Toulouse 3, CERPOP, UMR 1295, Toulouse, France., Zair Z; Inserm, University Paul Sabatier Toulouse 3, CERPOP, UMR 1295, Toulouse, France., Lenaud S; Program PACCI, Abidjan, Côte d'Ivoire., Vignon M; ALIMA, Dakar, Senegal., Ouedraogo Yugbare S; CHU de Bogodogo, Ouagadougou, Burkina Faso., Abarry H; Ministère de la santé, des populations et des affaires sociales, Niamey, Niger., Diakite AA; CHU Gabriel Touré, Bamako, Mali., Diallo IS; Institut de Nutrition et Santé de l'Enfant (INSE), Conakry, Guinea., Lamontagne F; SOLTHIS, Paris, France., Briand V; University of Bordeaux, Inserm UMR 1219, IRD EMR 271, Bordeaux Population Health Centre, Bordeaux, France., Dahourou DL; Inserm, University Paul Sabatier Toulouse 3, CERPOP, UMR 1295, Toulouse, France.; Institut de Recherche en Sciences de la Santé/CNRST, Département Biomédical, Santé Publique, Ouagadougou, Burkina Faso., Cousien A; Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, F-75018, Paris, France., Ridde V; IRD, CEPED, Paris, France., Leroy V; Inserm, University Paul Sabatier Toulouse 3, CERPOP, UMR 1295, Toulouse, France. valeriane.leroy@inserm.fr.; Center for Epidemiology and Research in Population Health (CERPOP), UMR 1295, Inserm, University Paul Sabatier Toulouse 3, Toulouse, France. valeriane.leroy@inserm.fr.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2022 Dec 24; Vol. 22 (1), pp. 1579. Date of Electronic Publication: 2022 Dec 24.
DOI: 10.1186/s12913-022-08982-4
Abstrakt: Background: The AIRE operational project will evaluate the implementation of the routine Pulse Oximeter (PO) use in the integrated management of childhood illness (IMCI) strategy for children under-5 in primary health care centers (PHC) in West Africa. The introduction of PO should promote the accurate identification of hypoxemia (pulse blood oxygen saturation Sp02 < 90%) among all severe IMCI cases (respiratory and non-respiratory) to prompt their effective case management (oxygen, antibiotics and other required treatments) at hospital. We seek to understand how the routine use of PO integrated in IMCI outpatients works (or not), for whom, in what contexts and with what outcomes.
Methods: The AIRE project is being implemented from 03/2020 to 12/2022 in 202 PHCs in four West African countries (Burkina Faso, Guinea, Mali, Niger) including 16 research PHCs (four per country). The research protocol will assess three complementary components using mixed quantitative and qualitative methods: a) context based on repeated cross-sectional surveys: baseline and aggregated monthly data from all PHCs on infrastructure, staffing, accessibility, equipment, PO use, severe cases and care; b) the process across PHCs by assessing acceptability, fidelity, implementation challenges and realistic evaluation, and c) individual outcomes in the research PHCs: all children under-5 attending IMCI clinics, eligible for PO use will be included with parental consent in a cross-sectional study. Among them, severe IMCI cases will be followed in a prospective cohort to assess their health status at 14 days. We will analyze pathways, patterns of care, and costs of care.
Discussion: This research will identify challenges to the systematic implementation of PO in IMCI consultations, such as health workers practices, frequent turnover, quality of care, etc. Further research will be needed to fully address key questions such as the best time to introduce PO into the IMCI process, the best SpO2 threshold for deciding on hospital referral, and assessing the cost-effectiveness of PO use. The AIRE research will provide health policy makers in West Africa with sufficient evidence on the context, process and outcomes of using PO integrated into IMCI to promote scale-up in all PHCs.
Trial Registration: Trial registration number: PACTR202206525204526 retrospectively registered on 06/15/2022.
(© 2022. The Author(s).)
Databáze: MEDLINE
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