06 Oct Finding the Best Tools to Reduce Child Pneumonia Deaths in Rural Cambodia – in Pictures
This article was originally published on Impatient Optimists and is cross-posted here with permission.
by: Monica Posada
As the leading causes of death in children under five in Cambodia, pneumonia still exacts a large toll on families in Cambodia. Many of the children who die from this condition are not given proper treatment, often as a result of misdiagnosis. With funding from the Bill & Melinda Gates Foundation, Malaria Consortium is taking on the challenge of reducing under-five pneumonia deaths by finding the best tools to diagnose its symptoms. By working together with the Ministry of Health, community health workers and facility-based health workers to test and evaluate existing tools as well as explore innovative diagnostic methods, the project will allow for better diagnosis and treatment in low-resource areas of the country. This photo gallery provides a glimpse into some of the work so far.
Photos copyright Malaria Consortium/Peter Caton
The first step of the project involved device selection, where the most promising existing devices for pneumonia diagnosis were identified for field testing. Here, a LIFEBOX Handheld Pulse Oximeter is on display – a device that measures oxygen levels in the blood to diagnose pneumonia.
The selected devices were then tested for accuracy against three reference standards. Training took place at Banlung city, in Ratanakiri province, where community health workers and first level health facility workers were taught to use the selected devices, which included pulse oximeters and respiratory rate timers. “I think Masimo smartphone is easier, I can see the results quickly. The other devices take a bit longer,” said Kay Raseu, a village malaria worker participating in the evaluations.
“I think this study is important,” said Rochom Wart, a 24-year-old village malaria worker who participated in the accuracy evaluation stage. “With these devices, now we can see the results on the screen so we can quickly know if the child is sick or not. I am happy to participate in this study because before I did not know how to use the devices in order to know if it is severe pneumonia or not.”
The health workers practiced using the devices by testing each other, and by conducting role plays with a life-size doll.
At Borkeo Referral Hospital, a Malaria Consortium employee explained the pneumonia diagnostics study to a community member and asked if she would be willing to have her child tested as part of the evaluation stage.
Keo Chetna, Expert Counter, placed a probe on a baby’s toe to measure his blood oxygen saturation level in order to detect pneumonia.
Ke Kosal, Malaria Consortium’s Field Research Assistant, observed how a village malaria worker conducted an assessment using a pulse oximeter device.
A family visitor cooked on an open fire at Banlung Hospital. It is the only referral hospital in Banlung district. From January to March 2015, around 100 pneumonia cases in children under five years old were diagnosed and treated.
Community members leaving Borkeo Referral Hospital, Ratanakiri, after having participated in the device testing. A total number of 402 children were assessed during this stage.
Residents of Kakthom village cooked at their house with a typical charcoal and wood stove. In-house smoke is a risk factor for pneumonia for children under five years old.
Romas Dean is a village malaria worker in Ratanakiri Province who took part in the training. After returning to her village, she continues to diagnose and treat malaria, diarrhoea and pneumonia in her rural community. Here, she used a respiratory rate timer to assess symptoms of a young child who had come to seek treatment at her house.
Romas Dean divides her time working as a village malaria worker and as a cassava farmer. “Sometimes people call us when we are working in the farm, then we come back to the village and treat them.”
The next and final stage of the Pneumonia Diagnostics Project is the field evaluation, which will be conducted from September to November 2015. The field evaluation will assess the feasibility of introducing the devices into the routine practice of community health workers and first line health facility workers, taking into account their feedback as well as that of patients and caregivers.
One of the most exciting aspects of the training for many health workers is that they will be able to use the improved technology to save lives in their communities. “We can help the community with these devices. In case of severe pneumonia, we can refer quickly to hospital and people will save money like this”, said Kay Raseu, a village malaria worker from Ochum District. ”With these devices it is easy to assess the child, since I can see the results quickly.”
Monica Posada is the Behaviour Change Communication Technical Specialist at Malaria Consortium, Cambodia. She is in charge of providing technical support for projects that combat targeted diseases and promote child and maternal health trough sustainable and innovative public health communications.