Malaria Consortium, London, UK.
Programme Division, Health Section, UNICEF, New York, NY, USA.
Acta Paediatr. 2020 Jun;109(6):1207-1220. doi: 10.1111/apa.15108. Epub 2019 Dec 16.
Pneumonia is the leading cause of child death after the neonatal period, resulting from late care seeking and inappropriate treatment. Diagnosis involves counting respiratory rate (RR); however, RR counting remains challenging for health workers and miscounting, and misclassification of RR is common. We evaluated the usability of a new automated RR counter, the Philips Children's Respiratory Monitor (ChARM), to Female Community Health Volunteers (FCHVs), and its acceptability to FCHVs and caregivers in Nepal.
A cross-sectional study was conducted in Jumla district, Nepal. About 133 FCHVs were observed between September and December 2018 when using ChARM during 517 sick child consultations, 264 after training and 253 after 2 months of routine use of ChARM. Acceptability of the ChARM was explored using semi-structured interviews.
FCHV adherence to guidelines after 2 months of using ChARM routinely was 52.8% (95% CI 46.6-58.9). The qualitative findings suggest that ChARM is acceptable to FCHVs and caregivers; however, capacity constraints such as older age and low literacy and impacted device usability were mentioned.
Further research on the performance, cost-effectiveness and implementation feasibility of this device is recommended, especially among low-literate CHWs.
肺炎是新生儿期后导致儿童死亡的主要原因，其原因是寻求医疗过晚和治疗不当。诊断包括计算呼吸频率（RR）；然而，RR 计数对卫生工作者来说仍然具有挑战性，并且计数错误和 RR 分类错误很常见。我们评估了一种新的自动 RR 计数器——飞利浦儿童呼吸监测仪（ChARM）在尼泊尔的女性社区卫生志愿者（FCHV）中的可用性，以及其对 FCHV 和照顾者的可接受性。
在尼泊尔珠穆拉区进行了一项横断面研究。2018 年 9 月至 12 月期间，当在 517 次患病儿童就诊时使用 CHARM 时，观察了大约 133 名 FCHV，其中 264 名在接受培训后，253 名在常规使用 CHARM 2 个月后。使用半结构化访谈探讨了 CHARM 的可接受性。
FCHV 在常规使用 CHARM 2 个月后的依从性为 52.8%（95%CI 46.6-58.9）。定性研究结果表明，ChARM 被 FCHV 和照顾者接受；然而，提到了一些能力限制因素，如年龄较大、文化程度较低和设备可用性受到影响。
建议进一步研究该设备的性能、成本效益和实施可行性，特别是在文化程度较低的 CHW 中。
