{
  "abstract": "Background The Integrated Management of Childhood Illness (IMCI) guidelines are implemented within primary health centres (PHCs) in resource-limited settings. These symptom-based algorithms under-diagnose severe hypoxemia, which contributes to the under-five’mortality in sub-Saharan Africa. To improve the diagnosis and management of severe hypoxaemia, the Améliorer l’Identification des détresses Respiratoires chez l’Enfant (AIRE) project implemented the routine use of pulse oximetry (PO) within IMCI consultations in Burkina Faso, Guinea, Mali and Niger. We described the intervention sites and measured their capacity to offer IMCI care prior to project implementation.Methods A cross-sectional quantitative survey was conducted in all the AIRE PHCs and their district hospitals (DHs) from March to July 2020.Results Overall, 215 PHCs and 8 DHs were surveyed. Almost all the PHCs were public structures, mainly managed by nurses. At least one healthcare worker was IMCI trained in >99% of PHCs. At baseline, PO was available in only 2/215 (1%) PHCs and 4/8 (50%) DH. Median referral rate was estimated to 1.5% per PHC; 35/215 (16%) PHCs had functional ambulances for managing referrals to DHs, including two with mobile oxygen. IMCI consultations were free of fees in Burkina Faso and Niger, but charged for in Guinea and Mali (from US$0.5 to US$1). All the DHs had capacities to provide specialised paediatric care, although the use of PO was not systematic. Oxygen was available at all DHs except one. Parents of children requiring hospitalisation had to pay out of pocket costs ranging from US$1.7 to US$8.4 per day.Conclusions This survey highlights the weak adoption of IMCI guidelines in these settings, the absence of PO’s at PHC level and their low use at hospital level, as well as difficulties in managing severe cases, referral to hospital and accessing oxygen. It has guided the choice of the AIRE research PHCs and the upgrading of PHCs including IMCI training.",
  "authors": [
    {
      "affiliations": [
        "Toulouse University, Inserm, Centre for Epidemiology and Research in Population Health (CERPOP), Toulouse, France"
      ],
      "name": "Kessièdé Gildas Boris Hedible"
    },
    {
      "affiliations": [
        "ALIMA, The Alliance for International Medical Action, Dakar, Sénégal"
      ],
      "name": "Gildas Mahena Anago"
    },
    {
      "affiliations": [
        "Programme PACCI, Abidjan, Côte d’Ivoire"
      ],
      "name": "Severin Lenaud"
    },
    {
      "affiliations": [
        "ALIMA, The Alliance for International Medical Action, Dakar, Sénégal"
      ],
      "name": "Désiré Neboua"
    },
    {
      "affiliations": [
        "Toulouse University, Inserm, Centre for Epidemiology and Research in Population Health (CERPOP), Toulouse, France"
      ],
      "name": "Zineb Zair"
    },
    {
      "affiliations": [
        "Tdh, Terre des hommes, Ouagadougou, Burkina Faso"
      ],
      "name": "Abdoul Guaniyi Sawadogo"
    },
    {
      "affiliations": [
        "CLERSE (Lille Centre for Sociological and Economic Research and Studies), University of Lille, Lille, France"
      ],
      "name": "Sarah Louart"
    },
    {
      "affiliations": [
        "Ministère de la santé, Ouagadougou, Burkina Faso"
      ],
      "name": "Valérie Zombré"
    },
    {
      "affiliations": [
        "Ministère de la Santé, Conakry, Guinea"
      ],
      "name": "Dieney Fadima Kaba"
    },
    {
      "affiliations": [
        "Ministère de la Santé et des affaires sociales, Bamako, Mali"
      ],
      "name": "Amadou Sidibe"
    },
    {
      "affiliations": [
        "Ministère de la santé, des populations et des affaires sociales, Niamey, Niger"
      ],
      "name": "Hannatou Abarry Souleymane"
    },
    {
      "affiliations": [
        "Tdh, Terre des hommes, Dakar, Sénégal"
      ],
      "name": "Sandrine Busière"
    },
    {
      "affiliations": [
        "ALIMA, The Alliance for International Medical Action, Dakar, Sénégal"
      ],
      "name": "Marine Vignon"
    },
    {
      "affiliations": [
        "Solthis, Solidarité Thérapeutique et Initiatives pour la Santé, Paris, France"
      ],
      "name": "Franck Lamontagne"
    },
    {
      "affiliations": [
        "Université Paris Cité and Université Sorbonne Paris Nord, IRD, Inserm, Ceped, F-75006, Paris, France",
        "Institut de Santé et Développement, Université Cheikh Anta Diop, Dakar, Sénégal"
      ],
      "name": "Valéry Ridde"
    },
    {
      "affiliations": [
        "Toulouse University, Inserm, Centre for Epidemiology and Research in Population Health (CERPOP), Toulouse, France"
      ],
      "name": "Valériane Leroy"
    },
    {
      "affiliations": [],
      "name": "for the AIRE Research Study Group"
    }
  ],
  "title": "Challenges and needs before implementing routine pulse oximetry within primary care for sick children in West Africa: baseline assessment within the AIRE project",
  "uid": "4c5a81a2-66e1-5ea6-98c8-4b0e502a91df"
}