Grant: Travel Awards - Institute Community Support

Newborn and child health remains one of the most significant health challenges in low-income countries (LICs). While knowledge on many interventions to improve newborn and child survival has advanced over the past few decades, healthcare systems in such settings remain unable to effectively deliver these life-saving interventions. A primary reason for this is that they have not been adapted to the contexts of LICs. For example, pediatric advanced life support management adapted for LICs has increasingly been advocated as a method to reduce under-five mortality. In response, Rwanda implemented ETAT+ (Emergency, Triage, Assessment and Treatment PLUS admission care), a locally adapted pediatric advanced life support management program to improve quality of hospital care for severely ill newborns and children. The program employs a multifaceted approach including evidence-based clinical practice guidelines, training, supervision and hospital audit. While our prior research assessed the baseline quality of hospital care for newborns and children in Rwanda and found great potential for impact from ETAT+, there has been no evaluation of the impact of the program in Rwanda. Therefore, this project aims to evaluate the impact of ETAT+ on newborn and child health outcomes in Rwanda. We will use sophisticated time series methods to assess the impact of ETAT+ on health outcomes including hospital mortality and length of hospital stay. We will also evaluate the real-world experiences with implementation of ETAT+ to identify barriers and facilitators to its successful implementation in order to provide evidence to guide its adoption and scale-up over time. This project will generate new evidence that can be used to improve the quality of hospital care and, ultimately, newborn and child health outcomes in Rwanda and other settings with similar context.