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GERTRUDE’S CHILDREN’S HOSPITAL Canadian Institutes of Health Research, International Infectious Disease and Global Health Training Programme (CIHR, IID & GHTP). Infectious Minds Gordon Otieno Odundo Chief Executive Gertrude’s Children’s Hospital

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Canadian Institutes of Health Research, International Infectious Disease and Global Health Training Programme (CIHR, IID & GHTP).This is a scholarship program run across four countries: Canada, Colombia, Kenya and India where advanced level students (PhD, Post Doctoral and Clinical fellows) undertake additional training on Infectious Diseases all geared towards being experts in matters pertaining to Global Health. Every month an 'Infectious Minds' sessionis held for two hours via a videoconference link across the four sites. On 15th May 2014 Gordon Otieno Odundo was the Guest Speaker presenting on infectious diseases in children the venue was at the University of Nairobi Institute of Tropical and Infectious Diseases, College of Health Sciences, Kenyatta National Hospital. The audience was primarily Doctoral (PhD) and Post-Doctoral students across the four sites; from Basic Science and Social Science disciplines. website: http://www.iidandghtp.com/

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Page 1: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

GERTRUDE’S CHILDREN’S HOSPITALCanadian Institutes of Health Research, International

Infectious Disease and Global Health Training Programme (CIHR, IID & GHTP).

Infectious Minds

Gordon Otieno OdundoChief Executive

Gertrude’s Children’s Hospital

Page 2: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Presentation Content

Discuss the major issues faced as a leader in the field especially with a focus on infections among children under 5 - and what is really neglected and needs more work done, or more investment from key stakeholders in the health industry

Page 3: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

The country has a young population, with 73% of residents aged below 30 years because of rapid population growth from 2.9 million to 40 million inhabitants over the last century. 1.5 million children are born each year

Page 4: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Hospital Entrance

Page 5: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Centres of Excellence

Page 6: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Our Network

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0

50000

100000

150000

200000

250000

300000

2000 2001 2002 2003 2004 2005 2006 2007 20082009 2010 2011 2012 2013

5106654953544836020464570

93981111927

153512

178050

206487224605

247898243954263564

Total Out Patient Attendances.

Year

Total

Years.

Tota

l no

of p

atien

ts.

Page 9: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Hospital Morbidity

Page 10: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Global under-five deaths, millions, 1990-2012  

Page 11: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

North Eastern

80

Eastern52

Rift Valley

59

Nyanza149

Western121

Central51

Nairobi64

Coast87

Child Health Situation- Kenya

Deaths per 1,000 live births for the 10-year period

before the survey

Kenya National Bureau of Statistics & ICF Macro

Kenya 74

Under-five Mortality by Province

Page 12: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Causes of Child Mortality - Kenya

April 10, 2023

Source: World Health Statistics 2011, WHO

16%

20%

9%

11%1%10%

10%

8%3%

19%3%

Pneumonia Diarrhoeal Causes HIV/AIDS Malaria Measles Prematurity Birth Asphyxia Neonatal Sepsis Congential Anomalies Other diseases Injuries

Cause DeathsTotal Deaths 188,928

Diarrhoea 38,802

Pneumonia 30,406

Malaria 20,666

Diarrhoea

Malaria

Neonatal causes = 31% of under 5 mortality

Page 13: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Child Health Situation- Kenya Progress in Infant and Under-five Mortality Rates, Kenya 1990/2009 (KDHS)

Page 14: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

National Setbacks

Inadequate resources /inefficient utilization of resources – human, commodities, financial etc

Focus on curative at expense of preventive and promotive care

Previous low focus on maternal newborn and child health

Health workers/community attitude

Page 15: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Government suggested Way forward

15

• Scale up interventions across the continuum of care – Pneumonia and diarrhoea plan being implemented through IMCI

• Focus on maternal and newborn care• Strengthen Health Systems and community

participation • Continue with efforts on control of malaria and HIV • Address the multi- sectoral challenges -

infrastructure, security, safe water, sanitation etc• Advocacy for increased resource allocation for

MNCH• Currently conducting countrywide Rapid Results

Initiatives (RRIs) on (a) increasing capacity to provide all the signal functions for basic emergency obstetric and newborn care and (b) on roll out of use of ORS and zinc for diarrhoea management

Page 16: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Discussion

• Provision of health services

• Addressing the social determinants of health

• Addressing the social determinants of equity.

Page 17: Infectious minds canadian institutes of health research, international infectious disease and global health training programme
Page 18: Infectious minds canadian institutes of health research, international infectious disease and global health training programme
Page 19: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Providing Health Services

Page 20: Infectious minds canadian institutes of health research, international infectious disease and global health training programme
Page 21: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Addressing the social determinants of health

Attending to the social determinants of health is especially important for children, since children’s experiences – of poverty, poor nutrition, trauma, abuse, neglect, the prenatal environment – can affect physical and mental health for an entire lifetime. As the authors of a recent commentary in JAMA write: “Pediatrics … continues to evolve clinical practice aimed at addressing social determinants because of children’s exquisite vulnerability to the deleterious effects of the social and physical environment, especially the aggregation of social factors associated with poverty.”

Page 22: Infectious minds canadian institutes of health research, international infectious disease and global health training programme

Addressing the social determinants of equity.

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Conclusion

There is an urgent need to increase immunization of children from the current

level to 100% of all children as this will reduce the social and financial costs of

treating diseaseThis will offer opportunities for poverty reduction and greater social economic

development as improved survival improves standards of living for all