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O PROFWASUNNAAGGREY, N PROFWEREFREDRICK. "Delivery of paediatric care at the first-referral level in Kenya. Lancet. 2004 Oct 30-Nov 5;364(9445):1622-9. English M, Esamai F, Wasunna A, Were F, Ogutu B, Wamae A, Snow RW, Peshu N.". In: Lancet. 2004 Oct 30-Nov 5;364(9445):1622-9. John Benjamins Publishing Company; 2004. Abstract

We aimed to investigate provision of paediatric care in government district hospitals in Kenya. We surveyed 14 first-referral level hospitals from seven of Kenya's eight provinces and obtained data for workload, outcome of admission, infrastructure, and resources and the views of hospital staff and caretakers of admitted children. Paediatric admission rates varied almost ten-fold. Basic anti-infective drugs, clinical supplies, and laboratory tests were available in at least 12 hospitals, although these might be charged for on discharge. In at least 11 hospitals, antistaphylococcal drugs, appropriate treatment for malnutrition, newborn feeds, and measurement of bilirubin were rarely or never available. Staff highlighted infrastructure and human and consumable resources as problems. However, a strong sense of commitment, support for the work of the hospital, and a desire for improvement were expressed. Caretakers' views were generally positive, although dissatisfaction with the physical environment in which care took place was common. The capacity of the district hospital in Kenya needs strengthening by comprehensive policies that address real needs if current or new interventions and services at this level of care are to enhance child survival.

O PROFWASUNNAAGGREY, N PROFMUSOKERACHEL. "Does the "Baby Cloche" heat shield keep low birth-weight infants warm? East Afr Med J . 1992 Jan; 69 ( 1 ): 37-9 . PMID: 1628548 [PubMed - indexed for MEDLINE] Brady JP, Wasunna AO, Bowker MH, Musoke RN.". In: East Afr Med J . 1992 Jan; 69 ( 1 ): 37-9 . John Benjamins Publishing Company; 1992. Abstract
Department of Paediatrics, University of Nairobi. To determine whether the "Baby Cloche" heat shield improves temperature control in low birth-weight infants we compared serial temperatures in 11 preterm infants nursed with or without the Cloche. Mean birth weights were 1490 and 1510 gm, mean weights at time of study 1680 and 1710 gm and mean postnatal age 20 and 27 days for study and control infants respectively. Serial measurements of rectal, abdominal skin, dorsum of the foot, Cloche wall and room temperature were recorded once or twice daily for 2 to 5 days. Mean rectal temperatures increased with increasing age from 35.3 in the first week of life to 37.0 degrees C by the third week (P less than 0.001). In infants nursed under the Cloche who were over 2 weeks of age mean rectal, abdominal and foot temperatures were 0.5, 0.6 and 1.6 degrees C higher (P less than 0.001); in younger infants there was no significant difference in any of the temperatures. Our findings suggest that the "Baby Cloche" improves temperature control in preterm infants over 1600 gm who are more than 2 weeks of age. PMID: 1628548 [PubMed - indexed for MEDLINE]

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