Kumar Harish, Sarin Enisha, Saboth Prasant, Jaiswal Avinash, Chaudhary Nidhi, Mohanty Jaya Swarup, Bisht Nitin, Tomar Shailendra Singh, Gupta Anil, Panda Ranjan, Patel Rachana, Kumar Arvind, Gupta Sachin, Alwadhi Varun
IPE Global, New Delhi, India.
Maternal Health, USAID India, New Delhi, India.
Clin Med Insights Pediatr. 2021 Nov 15;15:11795565211056649. doi: 10.1177/11795565211056649. eCollection 2021.
To address pneumonia, a major killer of under-5 children in India, a multimodal pulse oximeter was implemented in Health and Wellness Centers. Given the evidence of pulse oximetry in effective pneumonia management and taking into account the inadequate skills of front-line healthcare workers in case management, the device was introduced to help them readily diagnose and treat a child and to examine usability of the device.
The implementation was integrated with the routine OPD of primary health centers for 15 months after healthcare workers were provided with an abridged IMNCI training. Monthly facility data was collected to examine case management with the diagnostic device. Feedback on usefulness of the device was obtained.
Health and Wellness Centers (19) of 7 states were selected in consultation with state National Health Mission based on patient footfall.
Under-5 children presenting with ARI symptoms at the OPD.
Of 4846 children, 0.1% were diagnosed with severe pneumonia and 23% were diagnosed with pneumonia. As per device readings, correct referrals were made of 77.6% of cases of severe pneumonia, and 81% of pneumonia cases were correctly given antibiotics. The Pulse oximeter was highly acceptable among health workers as it helped in timely classification and treatment of pneumonia. It had no maintenance issue and battery was long-lasting.
Pulse oximeter implementation was doable and acceptable among health workers. Together with IMNCI training, PO in primary care settings is a feasible approach to provide equitable care to under-5 children.
为应对肺炎这一印度5岁以下儿童的主要杀手，健康与 wellness 中心引入了一种多模式脉搏血氧仪。鉴于脉搏血氧测定在有效管理肺炎方面的证据，并考虑到一线医护人员在病例管理方面技能不足，引入该设备以帮助他们快速诊断和治疗儿童，并检验该设备的可用性。
在医护人员接受简化的综合管理儿童疾病（IMNCI）培训后，该实施与初级卫生中心的常规门诊部门整合了15个月。每月收集机构数据以检查使用该诊断设备的病例管理情况。获得了关于该设备有用性的反馈。
根据患者流量，与邦国家卫生使命协商后，从7个邦的19个健康与wellness中心中进行了选择。
在门诊部门出现急性呼吸道感染（ARI）症状的5岁以下儿童。
在4846名儿童中，0.1%被诊断为重症肺炎，23%被诊断为肺炎。根据设备读数，77.6%的重症肺炎病例得到了正确转诊，81%的肺炎病例正确给予了抗生素。脉搏血氧仪在医护人员中非常受欢迎，因为它有助于及时对肺炎进行分类和治疗。它没有维护问题，电池续航时间长。
脉搏血氧仪的实施在医护人员中是可行且可接受的。与IMNCI培训一起，初级保健环境中的脉搏血氧测定是为5岁以下儿童提供公平护理的可行方法。
