1. Resources and Geographic Access to Care for Severe Pediatric Pneumonia in Four Resource-limited Settings
- Author
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Suzanne M. Simkovich, Lindsay J. Underhill, Miles A. Kirby, Mary E. Crocker, Dina Goodman, John P. McCracken, Lisa M. Thompson, Anaité Diaz-Artiga, Adly Castañaza-Gonzalez, Sarada S. Garg, Kalpana Balakrishnan, Gurusamy Thangavel, Ghislaine Rosa, Jennifer L. Peel, Thomas F. Clasen, Eric D. McCollum, William Checkley, Vigneswari Aravindalochanan, Dana B. Barr, Vanessa Burrowes, Devan Campbell, Eduardo Canuz, Howard Chang, Yunyun Chen, Marilú Chiang, Maggie L. Clark, Rachel Craik, Victor Dávila-Román, Lisa de las Fuentes, Oscar De Léon, Ephrem Dusabimana, Lisa Elon, Juan Gabriel Espinoza, Irma S. Pineda Fuentes, Savannah Gupton, Meghan Hardison, Stella Hartinger, Steven A. Harvey, Mayari Hengstermann, Phabiola Herrera, Shakir Hossen, Penelope Howards, Lindsay Jaacks, Shirin Jabbarzadeh, Michael A. Johnson, Abigail Jones, Katherine Kearns, Jacob Kremer, Margaret Laws, Patricia M. Lenzen, Jiawen Liao, Amy Lovvorn, Fiona Majorin, Julia McPeek, Rachel M. Meyers, J. Jaime Miranda, Erick Mollinedo, Lawrence Moulton, Krishnendu Mukhopadhyay, Luke Naeher, Abidan Nambajimana, Florien Ndagijimana, Azhar Nizam, Jean de Dieu Ntivuguruzwa, Aris Papageorghiou, Ricardo Piedrahita, Ajay Pillarisetti, Naveen Puttaswamy, Elisa Puzzolo, Ashlinn Quinn, Sarah Rajkumar, Usha Ramakrishnan, Davis Reardon, Joshua Rosenthal, P. Barry Ryan, Zoe Sakas, Sankar Sambandam, Jeremy Sarnat, Sheela Sinharoy, Kirk R. Smith, Kyle Steenland, Damien Swearing, Ashley K. Toenjes, Jean Damascene Uwizeyimana, Viviane Valdes, Amit Verma, Lance Waller, Megan Warnock, Kendra Williams, Wenlu Ye, and Bonnie Young
- Subjects
Pulmonary and Respiratory Medicine ,Referral ,business.industry ,Creative commons ,Original Articles ,low- and middle-income country ,Critical Care and Intensive Care Medicine ,medicine.disease ,Environmental and Occupational Lung Disease/Pediatrics and Lung Development ,pulse oximetry ,health service accessibility ,Pneumonia ,Intervention (counseling) ,Health care ,medicine ,pneumonia ,Humans ,Medical emergency ,Healthcare Disparities ,business ,Child ,License ,Limited resources ,Cause of death - Abstract
RATIONALE: Pneumonia is the leading cause of death in children worldwide. Identifying and appropriately managing severe pneumonia in a timely manner improves outcomes. Little is known about the readiness of healthcare facilities to manage severe pediatric pneumonia in low-resource settings. OBJECTIVES: As part of the Household Air Pollution Intervention Network (HAPIN) trial, we sought to identify healthcare facilities that were adequately resourced to manage severe pediatric pneumonia in Jalapa, Guatemala (J-GUA); Puno, Peru (P-PER); Kayonza, Rwanda (K-RWA); and Tamil Nadu, India (T-IND). We conducted a facility-based survey of available infrastructure, staff, equipment, and medical consumables. Facilities were georeferenced and a road network analysis was performed. MEASUREMENTS AND MAIN RESULTS: Of the 350 healthcare facilities surveyed, 13% had adequate resources to manage severe pneumonia, 37% had pulse oximeters, and 44% had supplemental oxygen. Mean (±SD) travel time to an adequately-resourced facility was 41±19 minutes in J-GUA, 99±64 minutes in P-PER, 40±19 minutes in K-RWA, and 31±19 minutes in T-IND. Expanding pulse oximetry coverage to all facilities reduced travel time by 44% in J-GUA, 29% in P-PER, 29% in K-RWA, and 11% in T-IND (all p
- Published
- 2021