2. Outline
• Why do we need this training
• Where did this training come from
• How is the training organised
• Who are the facilitators
• What are the aims of the training
• What is expected of participants
3. Why do we need training?
• What is wrong
with this child?
4. When did you last have access to
modern information?
5. Good practice?
• People are unaware of modern evidence on
best practice management
• Drug errors – some life-threatening – are
common
• Even simple resources, used correctly, can
save lives
• At present in Kenya there is much to
improve in the care of children
6. Where did the training come from?
• Evidence – research on the
best way to practice.
• World Health Organisation
& partners
• Adapted by Division of
Child Health, KEMRI,
University of Nairobi,
MTRH, Kenya Paediatric
Association
7. Internationally used training approach
• Emergency Triage and Treatment (ETAT),
WHO
• European Resuscitation Council and
Resuscitation Council of Kenya
8. This course is for ‘Inpatient IMCI’
Ministry of Health
Republic of Kenya.
Paediatric Protocols for District Hospitals.
December 2005
• Guidelines consistent
with OP IMCI
• Concentrate on
management of the
very sick / referred
child
9. How is the training organised?
• Lectures – knowledge
• Drills
• Skills training
• Scenarios
• Discussions
• Job aides
• Facilitators
• Exams!
Ministry of Health
Republic of Kenya.
Paediatric Protocols for District Hospitals.
December 2005
10. Drills, Skills and Scenarios
• For these sessions you will be broken up
into smaller groups
– It is important you know where you are going!
– We have colour coded you – stick with your
group
• We will be using ‘role-play’ and manikins –
you will get used to it!
13. Discussions
• The training can provide skills and
knowledge.
• Only the hospital staff can use these to
make improvements.
• Discussions aim to get your views on how
to help improve things locally.
14. Testing
• We will be testing people at the end of the
course.
– Multiple Choice Questions
– Testing basic skills
– There will be no attempts to trick people
– Only topics covered in the training will be included
in any tests
– Job aides can be used in the tests.
• We want people to do well!
16. The aims of the next 6 days
• To give people new knowledge & skills
• To give people simple tools that will help
them practice better paediatric care
• To encourage people to help children here
in the hospital – to do, not just know.
• We CANNOT make everyone a
paediatrician – always be on the lookout for
the unusual and seek advice or refer.
17. What is expected of participants?
• Can anyone see any problems with the
timetable – for the hospital or themselves?
18. What is expected of participants?
• Time:
– People need to arrive promptly
– People need to stick to time
– We are expecting all participants at all sessions
– You should have read the background material
• We want you to ask questions
• We want you to enjoy the training
• We want you to succeed with the training and help
improve the care of children in this hospital.
20. Please note
• The pictures / videos used to illustrate this
course come from WHO materials or were
specifically collected in Kenya according to
a protocol with Ethical approval and after
obtaining written informed consent from
parents.
21. Summary
• Just as the facilitators are putting in a lot of
effort we will expect participants to put in a
lot of effort AND keep to time.
• We share a common aim to provide the best
care we can to children in hospital – this
may mean changing old habits or ideas.
• Always feel free to ask.
Editor's Notes
#3:Ask the question – what is wrong with this child……the answer should be kwashiorkor…..but how do you tell if it is marasmic kwashiorkor?
What is the case fatality rate for this condition in Kenyan hospitals? – Probably about 25-30%! It should be <10%
What nutritional treatment is required….hopefully someone will answer ‘high-protein diet’, or you can comment….’who thinks a high protein diet is appropriate’? If such a diet is suggested then that is the answer why the training is needed – DO NOT go into why, this will be covered during the course.
#4:1) These photos are taken from the ‘library’ of a Kenyan district hospital. Books on X-ray crystallography and Nitrogen Fixation that are 20 years old are not much help to anyone!
#5:The results of a large survey carried out in 2002 demonstrated significant inadequacies in care of children in hospital.
In 2006 further work in 8 hospitals showed that major mistakes are being made and that knowledge has not improved.
#6:This new WHO publication (2006) summarises good practice. A considerable amount of work has gone in to summarising the evidence that underlies this good practice.
There have been several meetings and workshops with many groups in Kenya aimed at adapting the WHO approach to the Kenyan setting and making simple guidelines to cover common conditions.
#7:1) The training techniques for this course come from these two sources.
#8:The training uses a wide array of teaching techniques to make it interactive. Lectures are used to rapidly update individuals but most of the training is practical.
All the way through reference is made to job aides, including one recently produced for frontline health workers to cover common conditions.
#9:The training uses a wide array of teaching techniques to make it interactive. Lectures are used to rapidly update individuals but most of the training is practical.
All the way through reference is made to job aides, including one recently produced for frontline health workers to cover common conditions.
#10:1) The timetable is tight – people will be in the same groups all week so they should get used to sticking together.
#11:1) Most of the job aides are present in the booklet. People are free – and in fact are encouraged to – use them throughout the course even in the testing. People don’t need to remember anything.
#12:1) Some hospitals are trying new record forms for babies and children admitted to the hospital to help the admission process. These two are part of the training as they help summarise essential information.
#13:1) This slide can be hidden / deleted in courses that do not involve either the HIV module or the hospital’s self-assessment of quality of care.
#15:This slide can be hidden / deleted if not required but it would be good to ask facilitators to stand up and introduce themselves.
Introduce facilitators one by one.
The facilitators are there to help and NOT to criticise. You should feel free to ask them anything during the course
#16:1) The course may run from 4 to 5.5 days depending on the setting – adjust the title of the slide to reflect the adapted course you are running
#17:It is important to ask this first question. – If anyone has a problem one of the facilitators needs to find out what it is and how it will affect participation. There is probably little point someone attending only part of the course. It may be better to tell people who know they will need to miss several sessions that they should not begin the course.
#18:For all those who do not have a problem then we are making a contract – the facilitators will instruct and the participants will arrive on time and stick to time.
It is important the participants feel free to ask any question they like – no matter how foolish it appears
