Pneumonia takes the life of a child a minute – this is how most of these deaths can be prevented
This World Pneumonia Day we look at a new innovative health system strengthening approach that is saving children’s lives in Ghana.
Pneumonia remains the leading infectious cause of death among children under five, causing the deaths of around 700,000 children per year, the equivalent of at least one child every minute.
Yet, the disease is treatable with timely access to antibiotics and oxygen therapy.
In Ghana, UNICEF is working to ensure these life-saving treatments are available when and where children need them through the Scaling Pneumonia Response Innovations (SPRINT) programme which was launched in the Eastern Region of the country in February 2020.
The SPRINT model helps governments strengthen the quality of pneumonia care by training health staff, planning and implementing oxygen systems and increasing access to the antibiotic amoxicillin in the child-friendly dispersible tablet form.
Six-month-old baby Nyameba was brought to the emergency room by his father and aunt with a fever, cough and difficulty in breathing. “Sunday evening, he started coughing. Monday again he was coughing. So, yesterday we had to bring him to the hospital,” says his father, Bismark. “He was [having] difficulty breathing. You could hear noise in his chest.”
“When the baby was coughing, I was heartbroken, I was very distressed. Now I am very happy, I am seeing an improvement in his health, so I am okay.”
When a child has pneumonia, their lungs may fill with fluid which can make it difficult for them to breathe. This prevents enough oxygen from entering the bloodstream, a condition called hypoxemia which can be fatal if untreated.
Suite of oxygen equipment
Thanks to the SPRINT programme, the necessary suite of oxygen equipment was identified and made available, including diagnostics devices (such as pulse oximeters), oxygen cylinders and concentrators, and infant-sized nasal cannulas, which deliver oxygen to the children. Health care workers had also been trained in diagnosing and providing oxygen therapy.
“I can see now that his breathing is now normal, almost normal,” says Nyameba’s father.
“I feel happy. It feels good to see your child healthy, sound, not going through pain or any difficulty.”
In Ghana, the SPRINT model used UNICEF’s innovative Oxygen System Planning Tool to develop a structured and systematic approach to calculate oxygen demand and equipment needs based on the number of beds in a facility, the type of health facility, and a facility’s proximity to any existing oxygen plants. Following this a plan was developed to procure the equipment needed, train health workers in its use, and ensure the ongoing sustainable management and maintenance of equipment across the system.
Strengthening all levels of the health system
Oxygen can be the difference between life and death for children with pneumonia as well as sick newborns and COVID-19 patients. However, it is often not available in low-resource settings or at smaller health facilities and posts, which is the first place many caregivers attend when their child falls ill. Health workers need to know how to identify children in need of oxygen therapy, and how to safely administer and monitor it.
Eleven-month-old Philemon contracted pneumonia when he was just two weeks old. Struggling to breathe on his own, his family rushed him to the nearest health centre for treatment. However, the facility did not have the necessary equipment for diagnosis and treatment, and he had to be referred from hospital to hospital until he was finally able to be treated in Accra, the capital of Ghana, far from his home.
For this reason, SPRINT focuses on the continuum of care a child will receive. The innovative approach strengthens all levels of the health system – from major hospitals to smaller health facilities, right down to health posts close to the community – ensuring more children are accurately diagnosed where they first seek care and rapidly receive treatment.
The aim is for children to recover from the disease close to home, or to receive timely initial treatment while awaiting referral to larger facilities, if necessary.
“For those that do not need a referral, we are confident that we can actually treat them here. We can reduce under-fives mortality.”
Physician Assistant Victoria explains that prior to the introduction of SPRINT, many staff at her health centre struggled to diagnose and manage cases of pneumonia due to a lack of equipment.
“We didn’t have the basic devices,” she says. “When we even diagnosed a person, we couldn’t actually treat the person. We were referring most of our cases.”
“With the SPRINT initiative we were trained and supplied with devices like the pulse oximeters, oxygen concentrators, and amoxicillin. It makes diagnosis and treatment quite easy.”
“It feels great to know that when a child comes in that condition, even if the child needs a referral, you can at least do something before you refer the child.”
Ensuring access to antibiotics
The SPRINT programme also ensures the necessary antibiotics are available. The recommended treatment in low-resource settings is the dispersible tablet form of amoxicillin. Unlike liquid formulas of the antibiotic, dispersible tablets are easy for caregivers to prepare and provide the correct dose to their children at home.
The previously used liquid version of amoxicillin also had to be kept refrigerated to ensure the antibiotic remained effective, which is not possible for many families in low-resource settings who may not have access to refrigerators or electricity at home.
In Ghana, the SPRINT programme is now reaching thousands of children with pneumonia, ensuring they have access to the oxygen treatment and antibiotics they need to survive. Through improved oxygen systems, it has also benefitted numerous adult and pediatric patients, including COVID-19 patients, newborn babies and children severely sick with conditions such as meningitis, malaria, anemia and sickle cell disease.
But more must be done. Globally, at least one child dies of pneumonia every minute. We can prevent many of these deaths by continuing to strengthen health care systems and rapidly increasing access to oxygen and antibiotics.
UNICEF is seeking support to expand access to pneumonia treatment to more countries via SPRINT, which in turn improves the wider health system and ensures better care for all children and adult patients. For more information, read our investment case for SPRINT which provides key information on how you can support UNICEF’s fight to end childhood pneumonia.