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Pneumonia Careseeking Scorecard 2019

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What proportion of children with symptoms of pneumonia are taken to an appropriate healthcare provider?

 

This is a question that all countries should be asking as the answer is critical for the achievement of the Sustainable Development Goal for child survival (SDG 3.2) and progress towards Universal Health Coverage (UHC). Pneumonia is the leading cause of death among children under five years in most countries. Increasing the proportion of children who seek care when they are sick will be an essential tool to increase treatment rates and drive child pneumonia deaths to below 3 per 1,000 live births (the GAPPD target) and overall child deaths to below 25 per 1,000 live births (the SDG 3.2 target). Careseeking for a child exhibiting the symptoms of pneumonia is now the official indicator for “child treatment” in the UHC Service Coverage Index developed by the World Health Organization (WHO) and the World Bank. This means that countries seeking to achieve UHC must ensure that more than 90% of children with pneumonia symptoms are taken to an appropriate healthcare provider.

 

View the full report here.

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Levels and trends in child mortality 2019

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Above photo, credit to UNICEF, WHO, World Bank Group and United Nations

 

The United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) produces estimates of child and young adolescent mortality annually, reconciling the differences across data sources and taking into account the systematic biases associated with the various types of data on child and adolescent mortality. This report presents UN IGME’s latest estimates – through 2018 – of neonatal, infant and under-five mortality as well as mortality among children aged 5–14 years. It assesses progress in the reduction of child and young adolescent mortality at the country, regional and global levels, and provides an overview of the methods used to estimate the mortality indicators above.

 

Please view the full report here. 

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Gavi sets US$7·4 billion replenishment target

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Above, photo provided by Daphnee Cook / Save the Children. Susan, 4 months, receives a vaccination with the help of her mother Rebecca, 33.

 

By Ann Danaiya Usher

 

Published September 7, 2019

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Management of the Sick Young Infant Aged up to 2 Months

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Above photo, provided by WHO.

Please view the chart booklet here.

 

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Exploratory meeting to review new evidence for Integrated Management of Childhood Illness danger signs

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The World Health Organization, August 1, 2019

 

For children up to 5 years of age with common childhood illnesses, WHO’s IMCI strategy recommends using clinical signs for diagnosis, treatment and place-of-treatment decisions. In order to increase access to pneumonia treatment, in 2014 WHO revised pneumonia management guidance within IMCI. It now recommends that lower chest indrawing, which previously required hospitalization along with other referral clinical signs considered as danger signs for injectable antibiotics, be treated with oral amoxicillin on an outpatient basis in settings with low HIV prevalence. These danger signs include convulsions; unable to drink; unconscious or drowsy; vomiting everything; stiff neck; severe dehydration; stridor in a calm child; oedema on both feet; weight for height (WHZ) Z-score less than - 3 SD or mid-upper arm circumference (MUAC) less than 115 mm; severe palmar pallor; clouding of the cornea in a child with measles, and tender swelling behind the ear in a child with an ear problem.

 

However, a recent retrospective analysis of data from hospitalized children in Kenya showed that mortality was high among children with mild to moderate palmar pallor, WAZ less than - 3 SD and lower chest indrawing. This finding raised concerns that these children should be treated on an inpatient basis despite the revised guidelines. In order to evaluate the implications of this new evidence and other data and to identify questions for future research, a two-day exploratory meeting of pneumonia research experts, epidemiologists and child health specialists/paediatricians from a range of countries with varying resources was convened in Geneva, Switzerland, on 4–5 September 2018.

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Exploratory meeting to review new evidence for Integrated Management of Childhood Illness (IMCI) danger signs

The World Health Organization, August 1, 2019

 

For children up to 5 years of age with common childhood illnesses, WHO’s IMCI strategy recommends using clinical signs for diagnosis, treatment and place-of-treatment decisions. In order to increase access to pneumonia treatment, in 2014 WHO revised pneumonia management guidance within IMCI. It now recommends that lower chest indrawing, which previously required hospitalization along with other referral clinical signs considered as danger signs for injectable antibiotics, be treated with oral amoxicillin on an outpatient basis in settings with low HIV prevalence. These danger signs include convulsions; unable to drink; unconscious or drowsy; vomiting everything; stiff neck; severe dehydration; stridor in a calm child; oedema on both feet; weight for height (WHZ) Z-score less than - 3 SD or mid-upper arm circumference (MUAC) less than 115 mm; severe palmar pallor; clouding of the cornea in a child with measles, and tender swelling behind the ear in a child with an ear problem.

However, a recent retrospective analysis of data from hospitalized children in Kenya showed that mortality was high among children with mild to moderate palmar pallor, WAZ less than - 3 SD and lower chest indrawing. This finding raised concerns that these children should be treated on an inpatient basis despite the revised guidelines. In order to evaluate the implications of this new evidence and other data and to identify questions for future research, a two-day exploratory meeting of pneumonia research experts, epidemiologists and child health specialists/paediatricians from a range of countries with varying resources was convened in Geneva, Switzerland, on 4–5 September 2018.

Access article here

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Fighting for breath: how we can win the battle against childhood pneumonia

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Photo above, by ALAMY. Article written by Tedros Adhanom Ghebreyesus

"Most people reading this article will think of pneumonia as a threat to the lives of elderly people in rich countries. We invite you to think again. Today, pneumonia is the single biggest killer of children in developing countries - and it is time for the international community to come together and combat the disease

Pneumonia claims the lives of more than 800,000 children every year, making it the biggest infectious killer of under-fives. Almost all these fatalities are preventable. Yet with relentless predictability, the death-toll continues – claiming more than 100 young lives every hour. 

Most of the victims are less than two years old. Every death leaves grieving parents forced to watch helplessly as their children fight for breath against a disease that attacks their lungs and starves their bodies of oxygen. 

Stopping pneumonia is not a complex scientific challenge. Effective vaccines can prevent the most common causes of the disease. Early and accurate diagnosis, followed by treatment with a three-day course of antibiotics costing just 25 cents would cure most cases. For children with more severe cases, treatment with oxygen and higher levels of antibiotics offer a route to recovery..." 

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New projects aim to better identify critically ill children

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Above photo, Augustin Augier, ALIMA Executive Director ; Lelio Marmora, Unitaid Executive Director; Steve Davis, PATH CEO. Photo by Momcilo Orlovic/Unitaid 

 

"Geneva – ALIMA, PATH and Unitaid today announced a US$ 43 million initiative to put affordable, easy-to-use diagnostic devices into the hands of frontline health workers in Asia and Africa to help better identify critically ill children and refer them for treatment without delay.

 

The projects will focus on technologies that simultaneously address multiple diseases—including pneumonia, diarrhea and malaria—aligning with UN Sustainable Development Goals’ push for integrated approaches to global health."

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Low-cost pneumonia vaccine breaks into global market

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By Ann Danaiya Usher

The Lancet, May 18, 2019

 

The Executive Director of the Serum Institute Suresh Jadhav says that he expects the approval process to be completed before the end of the year.

Gavi has already included the new product in its line-up for next year, with a list price of $6 per immunised child. A Gavi spokesperson explained that a country wishing to introduce the new vaccine or to switch to the Serum Institute of India's product must first express demand for the vaccine. UNICEF then initiates procurement activities with the manufacturer. This process can start right away, although supply arrangements can only be finalised when the WHO prequalification is complete.”

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New York Times Releases Article Introducing Butterfly iQ As Diagnostic Tool For Early Stage Pneumonia

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The New York Times has just published an article featuring a new and exciting pneumonia diagnostic tool: Butterfly iQ. The Butterfly iQ scanners are primarily used to check for pneumonia, which is a major killer of children in poor countries and is frequently misdiagnosed. However, Dr. Cherniak and his team have found other exciting uses for the device. 

 

"The Butterfly is about the size of an electric shaver. It is battery-powered and contains microchips rather than piezoelectric crystals, so it usually won’t break if dropped. (That was accidentally tested a few times during a week that a reporter spent in rural Uganda with Dr. Cherniak’s team.)

For Butterfly Network, the Connecticut company that makes it, the profitable target customers are doctors and nurses who can afford a $2,000 device that fits in a coat pocket and is as portable as a stethoscope. But the scanner also has huge potential in rural Africa, Asia and Latin America, where the nearest X-ray machine may be hours away and the only CT and MRI scanners may be in the nation’s capital."

 

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The Center For Disease Dynamics, Economics & Policy: Access Barriers to Antibiotics

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by Isabel Frost, Jess Craig, Jyoti Joshi, and Ramanan Laxminarayan

 

 

"In this report, researchers at the Center for Disease Dynamics, Economics & Policy (CDDEP) conducted stakeholder interviews in Uganda, India, and Germany, and literature reviews to identify key access barriers to antibiotics in low-, middle-, and high-income countries.

 

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USAID, Just Launched: AI in Global Health

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Over the past several years, we have seen a wave of emerging technologies, from blockchain and Unmanned Aerial Vehicles (UAVs) to artificial intelligence (AI), demonstrate significant potential to alter and disrupt multiple sectors, including healthcare. All too often, though, the global health community is a late adopter of these promising new technologies. We believe that, as technologies like AI are still early-stage and rapidly evolving, the development community has an important opportunity to explore and shape the market to ensure that technologies are appropriately and effectively introduced and scaled.

 

Recognizing the huge potential of AI in global health, The Rockefeller Foundation and United States Agency for International Development’s (USAID) Center for Innovation and Impact (CII) have partnered, in close coordination with the Bill and Melinda Gates Foundation, to develop AI in Global Health: Defining a Collective Path Forward. This report identifies opportunities for donors, governments, investors, the private sector, and other stakeholders to explore and accelerate the appropriate development and cost-effective use of AI at scale in global health.

 

AI in Global Health:Explores the current state of the art of AI in healthcare to determine use cases with the highest potential in the global health contextAssesses the most critical challenges to scaling AI in low- and middle-income countries to understand which barriers may require more strategic and deliberate interventionExplores potential investments as part of a coordinated approach to funding this space effectively

 

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INFUSE 2019: Calling on innovators with solutions for immunizing in complex urban, developing country settings

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Above: Photo by Gavi/2016/Rachel Belt

 

In 2019, INFUSE is looking for innovations uniquely positioned to address immunisation challenges in urban settings. Through this call, Gavi is seeking innovations that aim to address the specific challenges involved in assuring that children living in urban areas are reached with immunisation.

 

In 2018, 55% of the world’s population lived in urban settings. By 2050, this figure is expected to rise to almost 70%. This rapid growth will add nearly 2.5 billion people to urban areas, with 90% of the expansion occurring in Asia and Africa.

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Overview of WHO recommendations on digital interventions for health system strengthening

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May 2, 2019   Presentations to the Digital Health and Innovations

sub-group of the Child Health Task Force

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Northwestern University team develops wireless sensors for intrapartum and newborn monitoring, published in Science

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Published in Science, 28 February 2019: A team from Northwestern University has published on their wireless sensor technology, used for intrapartum and newborn monitoring.

 

 

"In neonatal intensive care units (NICUs), continuous monitoring of vital signs is essential, particularly in cases of severe prematurity. Current monitoring platforms require multiple hard-wired, rigid interfaces to a neonate’s fragile, underdeveloped skin and, in some cases, invasive lines inserted into their delicate arteries. These platforms and their wired interfaces pose risks for iatrogenic skin injury, create physical barriers for skin-to-skin parental/ neonate bonding, and frustrate even basic clinical tasks. Technologies that bypass these limitations and provide additional, advanced physiological monitoring capabilities would directly address an unmet clinical need for a highly vulnerable population.

 

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The Pneumonia Innovations Network Partners with the American Thoracic Society

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We are pleased to announce that the Pneumonia Innovations Network has partnered with The American Thoracic Society (ATS)!

 

The ATS is a nonprofit organization focused on improving care for pulmonary diseases, critical illnesses and sleep-related breathing disorders. The PIN is a member of the ATS Public Advisory Roundtable (PAR), which represents a central component of the ATS and is the patient arm of the Society.   To learn more about the ATS and to get info on the ATS 2019 conference, visit their website.    
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EarlySense Selected by Save the Children for an Evaluation of Neonatal Health Monitoring Technologies in Africa

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The Evaluation is supported by a grant from the Bill & Melinda Gates Foundation and targeted to achieve reduction in Neonatal Mortality.

 

Woburn, MA, February 05, 2019 ­– EarlySense, the market leader in contact-free continuous monitoring solutions across the care continuum, announced today that it has been selected for a pilot project with Save the Children, an international nonprofit that works in 120 countries. This work is supported by a grant from the Bill & Melinda Gates Foundation. Continuous monitoring sensors will be tested first at Aga Khan University - Nairobi teaching hospital and then Pumwani Maternity Hospital, to monitor key health vitals of neonates in Nairobi, Kenya.

 

According to USAID, Sub-Saharan Africa has the world’s highest newborn death rate (34 per 1,000 births), with its infant deaths accounting for one-third of under-five deaths globally. With EarlySense sensors, nurses and physicians will be able to continuously track key vital signs, including heart rate and respiratory rate, as well as motion. This real-time monitoring is designed to provide a broad picture of neonates’ health and alert staff ahead of potential adverse events, enabling them to act quickly to improve care and prevent deaths. The contact-free sensor is placed under the bed mattress and requires no wires or hookups to the neonate.

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Newly released: WHO Operational Guide on Child Death Audits

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The WHO recently released new guidelines, "Improving the quality of paediatric care: an operational guide for facility-based audit and review of paediatric mortality," to Child Health Task Force members. 

 

"This new publication is focused on improving pediatric quality of care by providing guidance for establishing and conducting pediatric death audits and reviews. It assists health providers to identify patterns of morbidity, mortality, modifiable factors, and interventions to improve quality of care and outcomes in health facilities. As quality of care is a cross-cutting theme across our Child Health Task Force subgroups, we hope these guidelines may be of use in your work. Investigating a child's death shows the bereaved family and the community that the life of each child is important, the death is being taken seriously, and health workers are committed to learning and improving their practice."

 

Access the new guidelines here. 

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Dräger launches new respiratory support system for newborns

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PRESS RELEASE: January 28, 2019

 

Dräger has launched a new respiratory support system for newborns: Seattle PAP. Seattle PAP is a patented innovation developed in the USA for the treatment of respiratory distress symptoms in babies and children. It helps respond to the global need for an affordable, easy-to-use and easy-to-maintain respiratory support system for Neonatal Care.

 

How does Seattle PAP work? 

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The recent staggering decline in pneumonia R&D funding

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Pneumonia Innovations Network Co-Chair, Leith Greenslade shares the latest G-Finder Report figures that paint a grim picture: "According to the G-Finder Report, Global R&D funding for pneumonia drops sharply in 2017. Global R&D for pneumonia is at its lowest level since 2008."

 

 

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