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Research Article

A Multifaceted Intervention to Implement Guidelines and Improve Admission Paediatric Care in Kenyan District Hospitals: A Cluster Randomised Trial

  • Philip Ayieko mail,

    payieko@nairobi.kemri-wellcome.org (PA); menglish@nairobi.kemri-wellcome.org (ME)

    Affiliation: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya

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  • Stephen Ntoburi,

    Affiliation: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya

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  • John Wagai,

    Affiliation: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya

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  • Charles Opondo,

    Affiliation: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya

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  • Newton Opiyo,

    Affiliation: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya

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  • Santau Migiro,

    Affiliation: Division of Child Health, Ministry of Public Health and Sanitation, Nairobi, Kenya

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  • Annah Wamae,

    Affiliation: Division of Child Health, Ministry of Public Health and Sanitation, Nairobi, Kenya

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  • Wycliffe Mogoa,

    Affiliation: Ministry of Medical Services, Nairobi, Kenya

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  • Fred Were,

    Affiliation: Department of Paediatrics and Child Health, University of Nairobi, Kenyatta National Hospital, Nairobi, Kenya

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  • Aggrey Wasunna,

    Affiliation: Department of Paediatrics and Child Health, University of Nairobi, Kenyatta National Hospital, Nairobi, Kenya

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  • Greg Fegan,

    Affiliations: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya, Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom

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  • Grace Irimu,

    Affiliations: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya, Department of Paediatrics and Child Health, University of Nairobi, Kenyatta National Hospital, Nairobi, Kenya

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  • Mike English mail

    payieko@nairobi.kemri-wellcome.org (PA); menglish@nairobi.kemri-wellcome.org (ME)

    Affiliations: KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya, Department of Paediatrics, University of Oxford and John Radcliffe Hospital, Headington, Oxford, United Kingdom

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  • Published: April 05, 2011
  • DOI: 10.1371/journal.pmed.1001018

About the Authors

Philip Ayieko, Stephen Ntoburi, John Wagai, Charles Opondo, Newton Opiyo, Greg Fegan, Grace Irimu, Mike English
KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
Santau Migiro, Annah Wamae
Division of Child Health, Ministry of Public Health and Sanitation, Nairobi, Kenya
Wycliffe Mogoa
Ministry of Medical Services, Nairobi, Kenya
Fred Were, Aggrey Wasunna, Grace Irimu
Department of Paediatrics and Child Health, University of Nairobi, Kenyatta National Hospital, Nairobi, Kenya
Greg Fegan
Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
Mike English
Department of Paediatrics, University of Oxford and John Radcliffe Hospital, Headington, Oxford, United Kingdom

Corresponding Authors

Competing Interests

Santau Migiro, Wycliffe Mogoa, and Annah Wamae declared that they are employed by The Kenyan Government within the Ministries of Health and have responsibilities for child and newborn health. Mike English declares: 1. I coordinated the development of the multifaceted approach prior to its being tested in the trial. 2. I help coordinate provision of ETAT+ training on a voluntary basis (one component of the intervention) as attempts are made to provide the training to non-trial hospitals and within the University of Nairobi to trainee paediatricians and medical students. 3. I am attached to KEMRI and employed by Oxford University. 4. I sit on an advisory committee (unpaid) to the government of Kenya, the Child Health Interagency Coordinating Committee and have acted as a technical advisor to WHO on several occasions in the child and newborn health arena. There is no commercial aspect to the development of the training and other aspects of the intervention. In fact all training materials are freely available on the website http://www.idoc-africa.org. All the remaining authors have declared that no competing interests exist.

Author Contributions

ICMJE criteria for authorship read and met: P Ayieko, S Ntoburi, J Wagai, C Opondo, N Opiyo, S Migiro, A Wamae, W Mogoa, F Were, A Wasunna, G Fegan, G Irimu, M English. Agree with the results and conclusions: P Ayieko, S Ntoburi, J Wagai, C Opondo, N Opiyo, S Migiro, A Wamae, W Mogoa, F Were, A Wasunna, G Fegan, G Irimu, M English. Conceived and designed the experiments: A Wamae, F Were, A Wassuna, M English. Analyzed the data: P Ayieko, C Opondo, G Fegan, M English. Wrote the first draft: P Ayieko, M English. Wrote the paper: P Ayieko, M English. Obtained the funding for this project: M English. Provided and coordinated training and supervision: S Ntoburi, J Wagai, G Irimu, M English. Responsible for surveys, and analyses conducted to inform feedback: P Aiyeko, S Ntoburi, C Opundo, N Opiyo, J Wagai, G Irimu, M English.