Solar-powered oxygen, quality improvement and child pneumonia deaths: a large-scale effectiveness study
| Autor: | Jonah Karubi, Eleanor F. G. Neal, Trevor Duke, Magdalynn Kaupa, Ilomo Hwaihwanje, Hamish Graham, Rasa Izadnegahdar, Francis Pulsan, Susan Donath, Martin Sa'avu, Doreen Panauwe |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Adolescent Cost effectiveness Cost-Benefit Analysis Hospitals Rural medicine.medical_treatment Global Child Health Papua New Guinea 03 medical and health sciences symbols.namesake 0302 clinical medicine 030225 pediatrics Oxygen therapy Health care Solar Energy medicine Humans Oximetry 030212 general & internal medicine Poisson regression Mortality Child Developing Countries business.industry Incidence Incidence (epidemiology) Rural health Infant Newborn Oxygen Inhalation Therapy Health services research Infant Pneumonia medicine.disease Quality Improvement health services research Hospitalization Oxygen Child Preschool Pediatrics Perinatology and Child Health Emergency medicine symbols Health Facilities business Program Evaluation |
| Zdroj: | Archives of Disease in Childhood |
| ISSN: | 1468-2044 0003-9888 1261-6001 |
| Popis: | BackgroundPneumonia is the largest cause of child deaths in low-income countries. Lack of availability of oxygen in small rural hospitals results in avoidable deaths and unnecessary and unsafe referrals.MethodWe evaluated a programme for improving reliable oxygen therapy using oxygen concentrators, pulse oximeters and sustainable solar power in 38 remote health facilities in nine provinces in Papua New Guinea. The programme included a quality improvement approach with training, identification of gaps, problem solving and corrective measures. Admissions and deaths from pneumonia and overall paediatric admissions, deaths and referrals were recorded using routine health information data for 2–4 years prior to the intervention and 2–4 years after. Using Poisson regression we calculated incidence rates (IRs) preintervention and postintervention, and incidence rate ratios (IRR).ResultsThere were 18 933 pneumonia admissions and 530 pneumonia deaths. Pneumonia admission numbers were significantly lower in the postintervention era than in the preintervention era. The IRs for pneumonia deaths preintervention and postintervention were 2.83 (1.98–4.06) and 1.17 (0.48–1.86) per 100 pneumonia admissions: the IRR for pneumonia deaths was 0.41 (0.24–0.71, pConclusionsSolar-powered oxygen systems supported by continuous quality improvement can be achieved at large scale in rural and remote hospitals and health care facilities, and was associated with reduced child deaths and reduced referrals. Variability of effectiveness in different contexts calls for strengthening of quality improvement in rural health facilities.Trial registration numberACTRN12616001469404. |
| Databáze: | OpenAIRE |
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