Notes on contributorsBernard Olayo is a public health specialist and an entrepreneur from Kenya. He is the founder of the Center for Public Health and Development, a non-profit which has designed and developed two successful social enterprises -MediQuip Global (biomedical equipment repair and maintenance solutions) and Hewa Tele (a public-private venture delivering affordable oxygen in remote areas). He has over 14 years of experience managing complex public health programs in resource-limited settings in 15 countries across the globe. He is also a technical team member on several World Bank projects, primarily as a technical advisor to a number of ministries of health. Caroline Kendi Kirigia is a public health practitioner with training as a clinical officer, in project management, and a Masters in public health. Her 13 years of work experience ranges from HIV and TB prevention, care and treatment and team leadership with the University of California San Francisco and the Kenya Medical Research Institute's FACES programme to supporting the development of continuous quality improvement systems with HealthStrat and the Center for Public Health and Development in Kenya where she currently works in programmes. Her current work covers her interest areas of mental health, maternal health, newborn and child health. Jacquie Narotso Oliwa is a paediatrician, clinical epidemiologist, lecturer and a research fellow working on improving case detection of TB in children. She has 10 years of experience in medical education as a trainer for Paediatric TB, paediatric HIV Comprehensive Care Course; Paediatric TB; Paediatric Life support courses. She teaches child health and research methods at the University of Nairobi and has worked in health systems research collaborating with the Kenyan Ministry of Health and government hospitals in various quality improvement projects, pragmatic clinical observational studies trials and conducting systematic reviews. Odero Nicholas Agai is a Consultant Paediatrician and Child Health Specialist with 10 years hands-on experience both in the public and private sectors. He is also affiliated to The Centre for Public Health and Development, Kenya where he is a consultant and is actively involved in training of health care workers on innovative technology that are designed to reduce neonatal and childhood morbidity and mortality.
A randomized controlled trial recently demonstrated that continuous positive airway pressure (CPAP) effectively decreases respiratory rate in children presenting to Ghanaian district hospitals with respiratory distress. A follow-up study 16 months later evaluated the extent to which the skills and equipment necessary for CPAP use have been maintained. Seven of eight CPAP machines were functional, but five of eight oxygen concentrators and three of four electric generators were non-functional. Nurses trained by US study personnel (first-generation) and nurses trained by Ghanaian nurses after the study (second-generation) were evaluated on CPAP knowledge and skills. Twenty-eight nurses participated in the study, 9 first-generation and 19 second-generation. First-generation trainees scored significantly higher than second-generation trainees on both skills and knowledge assessments (p = 0.003). Appropriate technical support and training must be ensured to address equipment maintenance. Protocolization of the training program, in conjunction with skills and knowledge assessment, may improve acquisition and retention among second- and future-generation trainees.
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