ArticleGlobal health action2021
Paediatric Emergency Triage, Assessment and Treatment (ETAT) - preparedness for implementation at primary care facilities in Malawi.
Article in Global health action, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 21 citations in OpenAlex.
- Pathways of emergency care for severely ill children in Nigerian and Ugandan hospitals: A process mapping study.PLoS medicine · 2026Article
- The first pediatric emergency and critical care fellowship in sub-Saharan Africa: investing in local leaders to build subspecialty capacity in low- and middle-income countries.Frontiers in pediatrics · 2026Article
- Identifying barriers and facilitators to implementing triage systems in low- and middle-income countries: A scoping review.PLOS global public health · 2026Article
- Implementation of Smart Triage combined with a quality improvement program for children presenting to facilities in Kenya and Uganda: An interrupted time series analysis.PLOS digital health · 2025Article
- Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo - a mixed-methods study.Global health action · 2024Article
- Article
- Comparison between the Smart Triage model and the Emergency Triage Assessment and Treatment guidelines in triaging children presenting to the emergency departments of two public hospitals in Kenya.PLOS digital health · 2024Article
- Triage implementation in resource-limited emergency departments: sharing tools and experience from the Pacific region.International journal of emergency medicine · 2024Article
- Capacity for delivery of paediatric emergency care and the current use of emergency triage, assessment and treatment in health facilities in the Busoga region, Uganda-A mixed methods study.PLOS global public health · 2024Article
- Prospective cohort study of referred Malawian children and their survival by hypoxaemia and hypoglycaemia status.Bulletin of the World Health Organization · 2022Article
- Using self-supervised feature learning to improve the use of pulse oximeter signals to predict paediatric hospitalization.Wellcome open research · 2021Article
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe majority of deaths amongst children under 5 years are still due to preventable infectious causes. Emergency care has been identified as a key health system weakness, and referrals are often challenging.
objectiveWe aimed to establish how prepared frontline facilities in Malawi are to implement WHO Emergency Triage Assessment and Treatment (ETAT) guidelines, to support policy and planning decisions.
methodsWe conducted a concurrent mixed-methods study, including facility audit; healthcare provider survey; focus group discussions (FGD) and semi-structured interviews with facility staff. The study was conducted in two districts in Malawi, Zomba and Mchinji, between January and May 2019. We included all frontline facilities, including dispensaries, primary health centres, rural and community hospitals. Quantitative data were described using proportions, means and linear regression. Qualitative data was analysed using a framework approach. Data were analysed separately and then triangulated into common themes.
resultsForty-seven facilities and 531 healthcare providers were included in the audit and survey; 6 FGDs and 5 interviews were completed. Four common themes emerged: (1) current emergency case management; (2) referral practices; (3) trained staff capacity; (4) opportunities and barriers for ETAT. Triage was conducted in most facilities with various methods described, and 53% reporting all staff are responsible. Referrals were common, but challenging due to issues in transportation. Twelve percent of survey respondents had ETAT training, with clinical officers (41%) reporting this more frequently than other cadres. Training was associated with increased knowledge, independent of cadre. The main barriers to ETAT implementation were the lack of resources, but opportunities to improve quality of care were reported.
conclusionsMalawian frontline facilities are already providing a level of emergency paediatric care, but issues in training, drug supplies and equipment were present. To effectively scale-up ETAT, policies need to include supply chain management, maintenance and strengthening referral communication.
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