Continuous Positive Airway Pressure (CPAP)

Acute respiratory infection (ARI) is one of the leading causes of childhood morbidity and mortality throughout the world. Every 20 seconds, a child under 5 years of age dies from acute respiratory infection. Kenya has made great strides in addressing child mortality, by 2009, the infant mortality rates had reduced to 52 deaths per 1,000 live births from 77 in 2003, while the under-five mortality rate decreased to 74 deaths per 1,000 live births from 115 in 2003. That notwithstanding, acute respiratory infections continue to be a challenge in Kenya with 66% prevalence as reported in the 2014 Kenya Demographic Health Survey. Worth noting is that in 2015 pneumonia accounted for 15% of all deaths of children under 5 years old, killing an estimated 922 000 children.

Continuous positive airway pressure (CPAP) is a relatively low-cost technology that can improve outcomes in neonatal and pediatric patients with respiratory distress. The Centre for Public Health and Development has been at the forefront in advancing the CPAP technology. In most of the health facilities where sick children are admitted in Kenya airway management is not practical, due to lack of trained personnel, technology and monitoring capabilities. CPAP is a low-technology device that helps babies breathe easily, and gives caregivers the crucial time window to arrange for advanced care when needed.

In collaboration with Columbia University between July 2014 and April, 2016 CPHD implemented a program funded by General Electric Foundation to train health care workers as well as provide CPAP equipment and accessories. During the program duration CPAP was introduced in 13 hospitals namely; Pumwani Maternity Hospital, Kisumu County Hospital, Siaya County Referral Hospital, Kisii County Hospital, Busia County Hospital, Bungoma County Hospital, Kakamega County Hospital, Homabay County Hospital, Jaramogi Oginga Oginga Teaching and Referral Hospital, Migori County Hospital, Mama Lucy Hospital, Kiambu County Hospital and Machakos County Hospital. 79 health care workers of different cadres (18 pediatricians,15 medical officers, 39 nurses, 5 clinical officers and 2 public health specialists) were trained as a trainer of trainers (TOT). These clinicians then trained others in their respective facilities. The total cumulative usage of CPAP in the target facilities during the program implementation period was 1106, the majority of which were due to pneumonia/acute respiratory infection and prematurity/respiratory distress syndrome.

With the wrap up of the funded program, CPHD continues to facilitate the availability of CPAP equipment in various hospitals in Kenya through its sister company MEDIQUIP global.