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To assess readiness among primary public health facilities in Kenya to provide pre-referral antimalarials for severe malaria. Nine national surveys of randomly selected primary public health facilities undertaken bi-annually between 2017 and 2021 were analysed. The outcomes included the availability of pre-referral antimalarial drugs at the health facilities and health worker knowledge of recommended pre-referral treatment for severe malaria. A total of 1540 health workers from 1355 health facilities were interviewed. Injectable artesunate was available at 46%, injectable quinine at 7%, and artemether at 3% of the health facilities. None of the facilities had rectal artesunate suppositories in stock. A total of 960 (62%) health workers were trained on the use of injectable artesunate. 73% of the health workers who had ever referred a child with severe malaria were aware that artesunate was the recommended treatment, 49% said that intramuscular injection was the preferred route of administration, and 60% stated the correct dose. The overall knowledge level of the treatment policy was low at 21% and only slightly higher among trained than untrained health workers (24% vs 14%; p < 0.001) and those with access to guidelines versus those without access (29% vs 17%; p < 0.001). The readiness of primary health facilities and health workers to deliver appropriate pre-referral care to children with complicated malaria in Kenya is inadequate. Further investments are required to ensure (a) availability of nationally recommended pre-referral antimalarials; (b) appropriate training and supervision in their administration, and (c) monitoring of the entire referral process. © 2022 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Citation

Beatrice Amboko, Beatrice Machini, George Githuka, Philip Bejon, Dejan Zurovac, Robert W Snow. Readiness of the Kenyan public health sector to provide pre-referral care for severe paediatric malaria. Tropical medicine & international health : TM & IH. 2022 Mar;27(3):330-336

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PMID: 35094454

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