Status: Funded - Open
Evaluating a screening program to prioritize critically ill children in low resource clinics
Bhakti Hansoti, MBChB, MPH
BACKGROUND: 6.3 million children under the age of five died in 2013 and around 70% of these early child deaths are due to conditions that could be prevented or treated with access to simple, affordable interventions. Delays in the identification and treatment of critically ill children in low resource primary healthcare clinics leads to adverse outcomes, which if addressed could reduce under age five mortality by up to 40%.
GAP: Primary health care clinics see large volumes of patients with a wide range of illness severity, the IMICI strategy currently implemented in clinics requires expensive and unavailable nursing staff to implement, and thus critically ill children frequently experience harmful delays. We developed the Sick Children Require Emergency Evaluation Now (SCREEN) program, which uses a sensitive screening algorithm administered by laypersons, to rapidly identify critically ill children and expedite their care.
HYPOTHESIS: Can the SCREEN program be successfully implemented in primary healthcare centers in Cape Town, South Africa and what are the factors that should be addressed to strengthen implementation and scale-up of this program?
METHODS: This is an effectiveness-implementation hybrid study; a random sample of clinics will be enrolled to evaluate the effectiveness of the screening algorithm and the implementation of the SCREEN program in a real world environment (low resource primary healthcare clinics); a concurrent qualitative study will be conducted to contextualize the barriers and successes to implementation.
IMPACT: The information gathered form this study will be used to refine the current implementation strategy in the Western Cape and scale-up strategy for South Africa of the SCREEN program.
Johns Hopkins University
United States, South Africa