English Mike, Esamai Fabian, Wasunna Aggrey, Were Fred, Ogutu Bernhards, Wamae Annah, Snow Robert W, Peshu Norbert
KEMRI Centre for Geographic Medicine Research-Coast, PO Box 230, Kilifi, Kenya.
Lancet. 2004;364(9445):1622-9. doi: 10.1016/S0140-6736(04)17318-2.
We aimed to investigate provision of paediatric care in government district hospitals in Kenya. We surveyed 14 first-referral level hospitals from seven of Kenya's eight provinces and obtained data for workload, outcome of admission, infrastructure, and resources and the views of hospital staff and caretakers of admitted children. Paediatric admission rates varied almost ten-fold. Basic anti-infective drugs, clinical supplies, and laboratory tests were available in at least 12 hospitals, although these might be charged for on discharge. In at least 11 hospitals, antistaphylococcal drugs, appropriate treatment for malnutrition, newborn feeds, and measurement of bilirubin were rarely or never available. Staff highlighted infrastructure and human and consumable resources as problems. However, a strong sense of commitment, support for the work of the hospital, and a desire for improvement were expressed. Caretakers' views were generally positive, although dissatisfaction with the physical environment in which care took place was common. The capacity of the district hospital in Kenya needs strengthening by comprehensive policies that address real needs if current or new interventions and services at this level of care are to enhance child survival.
我们旨在调查肯尼亚县级政府医院的儿科护理服务情况。我们对来自肯尼亚八个省份中七个省份的14家一级转诊医院进行了调查，获取了工作量、住院结局、基础设施、资源以及医院工作人员和住院儿童看护人员的意见等数据。儿科住院率相差近十倍。至少12家医院备有基本抗感染药物、临床用品和实验室检测项目，不过出院时可能会收费。至少11家医院很少或根本没有抗葡萄球菌药物、营养不良的适当治疗方法、新生儿喂养用品和胆红素检测设备。工作人员强调基础设施、人力和消耗性资源存在问题。然而，他们表达了强烈的敬业精神、对医院工作的支持以及改进的愿望。看护人员的看法总体上是积极的，不过对护理的实际环境不满很常见。如果要通过当前或新的该护理层面干预措施和服务来提高儿童存活率，肯尼亚县级医院的能力需要通过解决实际需求的综合政策来加强。
