Journal: Bulletin of the World Health Organization

Article Title: Providing oxygen to children in hospitals: a realist review

doi: 10.2471/BLT.16.186676

Figure Lengend Snippet: Small-scale interventions to improve oxygen therapy systems in low-resource settings, identified by a systematic literature search

Article Snippet: 2000 , Malawi , Setting: 25 district and regional government hospitals. Challenges: low baseline clinical knowledge and skills of staff; poor access to oxygen; lack of guidelines; poor clinical documentation. Assets: initial sites were chosen if they had a functioning programme for management of acute respiratory infection or integrated management of childhood illness; and commitment from the district health office. Aims: to improve pneumonia case management and thereby reduce childhood pneumonia deaths. This was based on the theory that improved clinician capacity (skill and knowledge), together with a system that enables clinicians to follow guidelines (medications, equipment, support), would lead to improved quality of care (as per guidelines) and thus better clinical outcomes. , Strategy: based on the International Union Against Tuberculosis and Lung Disease (The Union) health-service delivery model, including political commitment; standardized diagnosis and treatment; clinical training; improved medication access; and recording and reporting child pneumonia outcomes. Improved oxygen systems were added to the initial plan, starting in 2002. Guidelines: an inpatient recording form for every child with pneumonia was introduced as both a clinical algorithm and a data collection form. Equipment: 26 oxygen concentrators (DeVilbiss), with flow-splitters in paediatric wards and 2–3 years’ supply of spare parts. Clinical training: comprehensive pneumonia-care training, including oxygen-related training, for nurses and medical officers (5-day course). Training was by project team at central location. Coverage was high (about 25% of health workforce), but follow-up in-service training failed. Maintenance: trained technicians from health ministry. Intention was to provide 3-monthly maintenance visits, but few visits were conducted, activities were not documented, and spare parts were lost. Partners: Malawi health ministry, The Union, the Bill & Melinda Gates Foundation and the Government of Scotland. , A nonrandomized field trial reported clinical outcomes. Long-term clinical and quality of care data were obtained from retrospective audits , and qualitative studies, – and provided by various reports , and a thesis. An external evaluation and a cross-sectional assessment of concentrators provided equipment data. .

Techniques: Battery

Journal: Bulletin of the World Health Organization

Article Title: Providing oxygen to children in hospitals: a realist review

doi: 10.2471/BLT.16.186676

Figure Lengend Snippet: Large-scale interventions to improve oxygen therapy systems in low-resource settings, identified by a systematic literature search

Article Snippet: 2000 , Malawi , Setting: 25 district and regional government hospitals. Challenges: low baseline clinical knowledge and skills of staff; poor access to oxygen; lack of guidelines; poor clinical documentation. Assets: initial sites were chosen if they had a functioning programme for management of acute respiratory infection or integrated management of childhood illness; and commitment from the district health office. Aims: to improve pneumonia case management and thereby reduce childhood pneumonia deaths. This was based on the theory that improved clinician capacity (skill and knowledge), together with a system that enables clinicians to follow guidelines (medications, equipment, support), would lead to improved quality of care (as per guidelines) and thus better clinical outcomes. , Strategy: based on the International Union Against Tuberculosis and Lung Disease (The Union) health-service delivery model, including political commitment; standardized diagnosis and treatment; clinical training; improved medication access; and recording and reporting child pneumonia outcomes. Improved oxygen systems were added to the initial plan, starting in 2002. Guidelines: an inpatient recording form for every child with pneumonia was introduced as both a clinical algorithm and a data collection form. Equipment: 26 oxygen concentrators (DeVilbiss), with flow-splitters in paediatric wards and 2–3 years’ supply of spare parts. Clinical training: comprehensive pneumonia-care training, including oxygen-related training, for nurses and medical officers (5-day course). Training was by project team at central location. Coverage was high (about 25% of health workforce), but follow-up in-service training failed. Maintenance: trained technicians from health ministry. Intention was to provide 3-monthly maintenance visits, but few visits were conducted, activities were not documented, and spare parts were lost. Partners: Malawi health ministry, The Union, the Bill & Melinda Gates Foundation and the Government of Scotland. , A nonrandomized field trial reported clinical outcomes. Long-term clinical and quality of care data were obtained from retrospective audits , and qualitative studies, – and provided by various reports , and a thesis. An external evaluation and a cross-sectional assessment of concentrators provided equipment data. .

Techniques: Infection, Medications, Biomarker Discovery, Control, Titration

Journal: Journal of Global Health

Article Title: Continuous Positive Airway Pressure (CPAP) for severe pneumonia in low- and middle-income countries: A systematic review of contextual factors

doi: 10.7189/jogh.12.10012

Figure Lengend Snippet: CPAP details of included studies

Article Snippet: McCollum 2019 [ ] , Bubble. Validated bCPAP system (Fisher and Paykel) , Oxygen concentrator (Airsep) , Oxygen concentrator (Airsep) , Either unvented nasal masks or nasal prongs , Integrated system's water reservoir , Integrated , Commercially available , .

Techniques: Saline, Sterility, Modification