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/

1. 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

2. 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

3. 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

4. Hospital Entrance

5. Centres of Excellence

6. Our Network

8. 300000
250000
200000
150000
100000
50000
0
Total no of patients.
5106654953544836020464570
Total Out Patient Attendances.
263564
247898243954
224605
206487
178050
153512
111927
93981
2000 2001 2002 2003 2004 2005 2006 2007 20082009 2010 2011 2012 2013
Years.
Year
Total

9. Hospital Morbidity

10. Global under-five deaths, millions, 1990-2012

11. Child Health Situation- Kenya
Under-five Mortality by Province
North
Eastern
80
Eastern
52
Rift
Valley
59
Western
121
Nyanza
149
Central
51
Nairobi
64
Coast
87
Deaths per 1,000 live births
for the 10-year period
before the survey
Kenya National Bureau of Statistics & ICF Macro
Kenya 74

12. Causes of Child Mortality - Kenya
Cause Deaths
Total Deaths 188,928
Diarrhoea 38,802
Pneumonia 30,406
Malaria 20,666
Neonatal
causes =
31% of
under 5
mortality
2 October 2014
3%
8%
Source: World Health Statistics 2011, WHO
16%
20%
9%
1% 11%
10%
10%
19%
3%
Pneumonia Diarrhoeal Causes HIV/AIDS Malaria
Measles Prematurity Birth Asphyxia Neonatal Sepsis
Congential Anomalies Other diseases Injuries

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

14. 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

15. 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

16. Discussion
• Provision of health services
• Addressing the social determinants of health
• Addressing the social determinants of equity.

19. Providing Health Services

21. 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.”

22. Addressing the social determinants of equity.

24. 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 disease
This will offer opportunities for poverty reduction and
greater social economic development as improved
survival improves standards of living for all