ArticleBMJ global health2025
Challenges and needs before implementing routine pulse oximetry within primary care for sick children in West Africa: baseline assessment within the AIRE project.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Beyond pulse oximetry: lessons from the AIRE project on translating innovation into improved child survival.BMJ global health · 2026Article
- Characterizing patients who benefit from mature medical AI models in real-world clinical applications.PLOS digital health · 2026Article
- Rethinking medical oxygen investments in primary health care in Nigeria.Frontiers in public health · 2026Article
- Care management and determinants of day 14 mortality in severely ill children aged under 5 years subsequent to hypoxaemia diagnosed using routine pulse oximetry in primary care: evidence from the AIRE project.BMJ global health · 2025Article
- Care pathways for critically ill children aged 0-5 years arriving at district hospitals in Burkina Faso, Guinea, Mali, and Niger (2022): a cross-sectional study.BMC public health · 2025Article
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17 authors.
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Abstract
backgroundThe 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.
methodsA cross-sectional quantitative survey was conducted in all the AIRE PHCs and their district hospitals (DHs) from March to July 2020.
resultsOverall, 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.
conclusionsThis 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.
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