Publication:

Institutionalizing the Management of Sick Young Infants: Kenya’s Experience in Revising National Guidelines on Integrated Management of Newborn and Childhood Illnesses

ntroduction: In 2015, the World Health Organization (WHO) developed guidelines for the management of sick young infants (SYIs) with possible serious bacterial infection (PSBI) where refer- ral is not feasible. The Ponya Mtoto project was designed as an implementation research project to demonstrate how to adopt the WHO PSBI guidelines in the Kenyan context. Ponya Mtoto Project Description: Between October 2017 and June 2021, Ponya Mtoto was implemented in 4 Kenyan counties with higher infant and newborn mortality rates than the national mean. A total of 48 health facilities stratified by level of services were selected as study sites. Implementation Approach: The following activities were done to institutionalize the management of SYIs with PSBI where referral is not feasible in Kenya’s health system: (1) participating in a cocreation workshop and development of a theory of change; (2) revising the national integrated management of newborn and childhood illnesses guidelines to incorporate the manage- ment of PSBI where referral is not feasible; (3) improving avail- ability of essential commodities; (4) strengthening provider confidence in the management of SYIs; (5) strengthening aware- ness about PSBI services for SYIs at the community level; and (6) harmonizing the national integrated management of newborn and childhood illnesses guidelines to address discrepancies in the content on the management of PSBI. In addition, the project fo- cused on strengthening quality of care for SYIs and using imple- mentation research to track progress in achieving project targets and outcomes. Conclusion: Using an implementation research approach to intro- duce new WHO guidelines on PSBI where referral is not feasible into Kenya’s health care service was critical to fostering engage- ment of a diverse range of stakeholders, monitoring provider skills and confidence-building, strengthening provision of key commodi- ties for managing SYIs with PSBI, and sustaining community-facility linkages.