BackgroundPaediatric emergency departments have seen reduced attendance during the COVID-19 pandemic. Late paediatric presentations may lead to severe illness and even death. Maintaining provision of healthcare through a pandemic is essential. This qualitative study aims to identify changing care-seeking behaviours in child health during the pandemic and ascertain parental views around barriers to care.MethodsSemistructured interviews were conducted with caregivers of children accessing acute paediatric services in a hospital in North-West London. Thematic content analysis was used to derive themes from the data, using a deductive approach.ResultsFrom interviews with 15 caregivers an understanding was gained of care-seeking behaviours during the pandemic. Themes identified were; influencers of decision to seek care, experience of primary care, other perceived barriers, experiences of secondary care, advice to others following lived experience. Where delays in decision to seek care occurred this was influenced predominantly by fear, driven by community perception and experience and media portrayal. Delays in reaching care were focused on access to primary care and availability of services. Caregivers were happy with the quality of care received in secondary care and would advise friends to seek care without hesitation, not to allow fear to delay them.ConclusionA pandemic involving a novel virus is always a challenging prospect in terms of organisation of healthcare provision. This study has highlighted parental perspectives around access to care and care-seeking behaviours which can inform us how to better improve service functioning during such a pandemic and beyond into the recovery period.

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ObjectivesNeonatal mortality remains persistently high in low-income and middle-income countries. In Cambodia, there is a paucity of data on the perception of neonatal health and care-seeking behaviours at the community level. This study aimed to identify influencers of neonatal health and healthcare-seeking behaviour in a rural Cambodian province.DesignA qualitative study using focus group discussions and thematic content analysis.SettingFour health centres in a rural province of Northern Cambodia.ParticipantsTwenty-four focus group discussions were conducted with 85 community health workers in 2019.ResultsCommunity health workers recognised an improvement in neonatal health over time. Key influencers to neonatal health were identified as knowledge, sociocultural behaviours, finances and transport, provision of care and healthcare engagement. Most influencers acted as both barriers and facilitators, with the exception of finances and transport that only acted as a barrier, and healthcare engagement that acted as a facilitator.ConclusionUnderstanding health influencers and care-seeking behaviours is recognised to facilitate appropriate community health programmes. Key influencers and care-seeking behaviours have been identified from rural Cambodia adding to the current literature. Where facilitators have already been established, they should be used as building blocks for continued change.

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Objective Paediatric Assessment Illness Resuscitation and Stabilisation Course (PAIRS) is an accredited one day course developed in Dublin for resource limited settings. The aim of this project was to deliver this course to front line paediatric staff in a south eastern Nigerian hospital. Methods The course was delivered over 8 hours daily for 3 days with breaks in-between. On the 4th day, a number of delegates including doctors and senior nurses who had attended one of the 3 days were invited to participate in a more intensive course to develop more advanced skills in paediatric resuscitation and management of sick children. Delegates' knowledge was tested and they received certificates of completion at the end of the course. Results Over the 4 days, 214 paediatric healthcare workers (136 doctors, 77 nurses, 1 'other') representing 21 hospitals were trained on a structured approach in the assessment and resuscitation of serious illness in children, team work and communication, paediatric early warning system and basic life support. Delegates reported increased knowledge and competency in the management of paediatric emergencies. Conclusion The World Health Organisation (WHO) estimates that about five children under 5 years of age die in Africa every minute. More than half of these child deaths are due to conditions that are preventable or treatable with simple interventions. Teaching paediatric resuscitation enhances the skills of paediatric responders and has been shown to directly reduce morbidity and improve patient survival. This course enhanced their knowledge and helped the participants formulate tools required for early recognition and monitoring of illness progression in paediatric patients. On completion of the course, a local faculty was also instated to commence simulation training in the local hospital with support from the Ireland faculty. The training was well received and had a lot of positive feedback.