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

BMC Health Services Research

Study Protocol

Sory Keita¹  G. Désiré Kargougou¹  Abdoul Salam Savadogo²  Jacques Séraphin Kolié²  Désiré Neboua³  MarineVignon³  Gildas Anago³  Sarah Louart⁴  Abdoul Aziz Diakite⁵  Solange Ouedraogo Yugbare⁶  Valéry Ridde⁷  Laura Catala⁸  Lucie Peters-Bokol⁸  Gildas Boris Hedible⁸  Honorat Agbeci⁸  Zineb Zair⁸  Valériane Leroy⁹  Désiré Lucien Dahourou^1,10  Ibrahima Sory Diallo^1,11  Hannatou Abarry^1,12  Severin Lenaud^1,13  Mactar Niome^1,14  Bertrand Meda^1,14  Franck Lamontagne^1,15  Abdoul-Guaniyi Sawadogo^1,16  Adama Hema^1,16  Valérie Briand^1,17  Anthony Cousien^1,18 

[1] ALIMA, Bamako, Mali;ALIMA, Conakry, Guinea;ALIMA, Dakar, Senegal;ALIMA, Dakar, Senegal;IRD, CEPED, Paris, France;University of Lille, CLERSE - Centre Lillois d’Études et de Recherches Sociologiques et Économiques, Lille, France;CHU Gabriel Touré, Bamako, Mali;CHU de Bogodogo, Ouagadougou, Burkina Faso;IRD, CEPED, Paris, France;Inserm, University Paul Sabatier Toulouse 3, CERPOP, UMR 1295, Toulouse, France;Inserm, University Paul Sabatier Toulouse 3, CERPOP, UMR 1295, Toulouse, France;Center for Epidemiology and Research in Population Health (CERPOP), UMR 1295, Inserm, University Paul Sabatier Toulouse 3, Toulouse, France;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;Institut de Nutrition et Santé de l’Enfant (INSE), Conakry, Guinea;Ministère de la santé, des populations et des affaires sociales, Niamey, Niger;Program PACCI, Abidjan, Côte d’Ivoire;SOLTHIS, Niamey, Niger;SOLTHIS, Paris, France;Terre des hommes-Lausanne (Tdh), Ouagadougou, Burkina Faso;University of Bordeaux, Inserm UMR 1219, IRD EMR 271, Bordeaux Population Health Centre, Bordeaux, France;Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, F-75018, Paris, France;

关键词: Children;    Integrated management of childhood illness;    Pulse oximeter;    Primary health care;    West Africa;    Implementation research;   

DOI  :  10.1186/s12913-022-08982-4

 received in 2022-11-26, accepted in 2022-12-16,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsThe 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.DiscussionThis 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 registrationTrial registration number: PACTR202206525204526 retrospectively registered on 06/15/2022.

【 授权许可】

CC BY   
© The Author(s) 2022

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