About Ponya Mtoto
In recent years, the implementation of several initiatives has led to a reduction in the mortality rate of newborns, infants & under-fives in Kenya. However, the neonatal mortality rate (NMR) has shown the slowest decline in the last 10 years. Neonatal infections are a leading cause of NMR, with sepsis contributing up to 20% of deaths. In line with the global targets, the 2014-30 Kenya Health Policy aims to reduce the NMR from 22 to 12 per 1000 live births by 2030.
However, to “End preventable deaths” and “Keeping every child alive,” further action is needed to ensure effective implementation of Integrated Management of Childhood Infections (IMCI). The World Health Organization (WHO) treatment for possible serious bacterial infections (PSBI) in young infants entails in-patient hospitalization and administration of multi-drug, multi-dose injectable antibiotics for at least 7-10 days. Yet, hospitalization is not always available, accessible or affordable to the sick young infants (see Box 1). Less than 30% of those referred can access hospital care.
Managing Sick Young Infants Where Referral Is Not Feasible
When referral is not feasible, infants often receive no treatment, resulting in unnecessary, potentially preventable infection-related newborn deaths. To address these challenges, a multi-country study on the use of simplified regimens for managing PSBI in young infants (0-59 days) was conducted in several countries in Asia and Africa including Kenya. Results showed that simplified antibiotic regimens on an outpatient basis were as effective as the WHO standard treatment regimen. Based on these findings, WHO developed guidelines on management of PSBI in sick young infants (SYIs), when referral is not feasible. Between September 2015 and October 2017, the guidelines were tested – using Implementation Research within specific health system contexts in Nigeria, DRC, Ethiopia, Malawi, Pakistan, Bangladesh and India. Results from this phase were disseminated in January 2018 in Addis Ababa, Ethiopia. Despite different implementation experiences, the studies showed that simplified antibiotic regimens could effectively be administered to SYIs in outpatients or in primary health care facilities when referral is not feasible.
About The PSBI Project In Kenya
The overall goal of the project (October 2017-September 2020) is to contribute to reductions in young infant deaths from PSBI. The project has four result areas:
• Result 1: New PSBI guidelines included in updated IMCI training and
• Result 2: New PSBI guidelines implementation demonstrated as feasible,
acceptable, and sustainable in representative settings
• Result 3: Increased utilization of quality PSBI care
• Result 4: National policy change to IMCI, PNC, PSBI mgt & other RH areas
The PSBI project is a partnership between the Kenya Paediatric Research
Consortium, Mount Kenya University (MKU) and the Population Council. The partnership seeks to support the MOH at all levels to:
✓ engage local health systems to improve young infant PSBI activities.
✓ promote continuous learning and information dissemination,
✓ document learning and adaptation approaches with a view to identifying
and addressing health system readiness challenges
✓ develop site specific innovations and programmatic strategies in response
to their various implementation challenges.
✓ improve the impact and sustainability of PSBI programming in Kenya.