Resource Allocation in the Pediatric Intensive Care Unit in Rwanda
References
- Slusher TM, Kiragu AW, Day LT, et al. Pediatric critical care in resource‑limited settings: Overview and lessons learned. Front Pediatr. 2018;6:49. doi:10.3389/fped.2018.00049.
- UNIGME. Levels & trends in child mortality: Report 2022, estimates developed by the United Nations Inter‑agency Group for Child Mortality Estimation (UNIGME). 2023.
https://childmortality.org/wp-content/uploads/2023/01/UN-IGME-Child-Mortality-Report-2022.pdf - GBD 2016 Lower Respiratory Infections Collaborators. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis. 2016;18(11):1191–1210. doi:10.1016/S1473-3099(18)30310-4.
- Anesi GL, Kerlin MP. The impact of resource limitations on care delivery and outcomes: Routine variation, the coronavirus disease 2019 pandemic, and persistent shortage. Curr Opin Crit Care. 2021;27(5):513–519. doi:10.1097/MCC.0000000000000859.
- Basnet S, Adhikari N, Koirala J. Challenges in setting up pediatric and neonatal intensive care units in a resource‑limited country. Pediatrics. 2011;128(4):e986–e992. doi:10.1542/peds.2010-3657.
- Bazirete O, Nzayirambaho M, Umubyeyi A, Uwimana MC, Evans M. Influencing factors for prevention of postpartum hemorrhage and early detection of childbearing women at risk in Northern Province of Rwanda: Beneficiary and health worker perspectives. BMC Pregnancy Childbirth. 2020;20(1):678. doi:10.1186/s12884-020-03389-7.
- Edae G, Tekleab AM, Getachew M, Bacha T. Admission pattern and treatment outcome in pediatric intensive care unit, tertiary hospital, Addis Ababa, Ethiopia. Ethiop J Health Sci. 2022;32(3):497–504. doi:10.4314/ejhs.v32i3.4.
- Biskup T, Phan P, Grunauer M. Lessons from the design and implementation of a pediatric critical care and emergency medicine training program in a low resource country: The South American experience. J Pediatr Intensive Care. 2017;6(1):60–65. doi:10.1055/s-0036-1584678.
- Horak RV, Griffin JF, Brown AM, et al. Growth and changing characteristics of pediatric intensive care 2001–2016. Crit Care Med. 2019;47(8):1135–1142. doi:10.1097/CCM.0000000000003863.
- Nyirasafari R, Corden MH, Karambizi AC, et al. Predictors of mortality in a paediatric intensive care unit in Kigali, Rwanda. Paediatr Int Child Health. 2016;37(2):109–115. doi:10.1080/20469047.2016.1250031.
- Purcell LN, Prin M, Sincavage J, Kadyaudzu C, Phillips MR, Charles A. Outcomes following intensive care unit admission in a pediatric cohort in Malawi. J Trop Pediatr. 2020;66(6):621–629. doi:10.1093/tropej/fmaa025.
- Brown SR, Martinez Garcia D, Agulnik A. Scoping review of pediatric early warning systems (PEWS) in resource‑limited and humanitarian settings. Front Pediatr. 2018;6:410. doi:10.3389/fped.2018.00410.
- Rosman SL, Karangwa V, Law M, Monuteaux MC, Briscoe CD, McCall N. Provisional validation of a pediatric early warning score for resource‑limited settings. Pediatrics. 2019;143(5):e20183657. doi:10.1542/peds.2018-3657.
- Rosman SL, Daneau Briscoe C, Rutare S, et al. The impact of pediatric early warning score and rapid response algorithm training and implementation on interprofessional collaboration in a resource‑limited setting. Cook R, ed. PLoS One. 2022;17(6):e0270253. doi:10.1371/journal.pone.0270253.
- Nzasabimana P, Ignatowicz A, Alayande BT, et al. Barriers to equitable access to quality trauma care in Rwanda: A qualitative study. BMJ Open. 2023;13(9):e075117. doi:10.1136/bmjopen-2023-075117.
- Rwanda Social Security Board. Community Based Health Insurance. Published 2025.
https://www.rssb.rw/scheme/cbhi-scheme . - Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021;49(11):e1063–e1143. doi:10.1097/CCM.0000000000005337.
- Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580–637. doi:10.1097/CCM.0b013e31827e83af.
- R Core Team. R: A Language and Environment for Statistical Computing, 4.3.1. Published online 2022. Accessed June 13, 2023.
https://www.R-project.org/ . - Surviving sepsis campaign international guidelines. Pediatrics. 2020;145(5):e20200629. doi:10.1542/peds.2020-0629.
- Weiss SL, Peters MJ, Alhazzani W, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis‑associated organ dysfunction in children. Pediatr Crit Care Med. 2020;21(2):e52–e106. doi:10.1097/PCC.0000000000002198.
- Downie L, Armiento R, Subhi R, Kelly J, Clifford V, Duke T. Community‑acquired neonatal and infant sepsis in developing countries: Efficacy of WHO’s currently recommended antibiotics‑‑systematic review and meta‑analysis. Arch Dis Child. 2013;98(2):146–154. doi:10.1136/archdischild-2012-302033.
- Thwaites L, Nasa P, Abbenbroek B, et al. Management of adult sepsis in resource‑limited settings: Global expert consensus statements using a Delphi method. Intensive Care Med. 2025;51(1):21–38. doi:10.1007/s00134-024-07735-7.
- Martin K, Weiss SL. Initial resuscitation and management of pediatric septic shock. Minerva Pediatr. 2015;67(2):141–158.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395852/ . - Melendez E, Bachur R. Quality improvement in pediatric sepsis. Curr Opin Pediatr. 2015;27(3):298–302. doi:10.1097/MOP.0000000000000222.
- WHO.
World Health Organization Model List of Essential Medicines for children – 9th list. Presented at: The selection and use of essential medicines 2023: Executive summary of the report of the 24th WHO Expert Committee on the Selection and Use of Essential Medicines (WHO/MHP/HPS/EML/2023.03) . Geneva: World Health Organization; April 24, 2023. License: CC BY‑NC‑SA 3.0 IGO - Sonenthal PD, Kasomekera N, Connolly E, et al. Critical care units in Malawi: A cross‑sectional study. Ann Glob Health. 2023;89(1):51. doi:10.5334/aogh.4053.
- Bizimana T, Kayumba PC, Heide L. Prices, availability and affordability of medicines in Rwanda. PLoS One. 2020;15(8):e0236411. doi:10.1371/journal.pone.0236411.
- Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373–1379. doi:10.1016/s0895-4356(96)00236-3.
DOI: https://doi.org/10.5334/aogh.4714 | Journal eISSN: 2214-9996
Language: English
Submitted on: Feb 13, 2025
Accepted on: Jul 8, 2025
Published on: Aug 26, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
© 2025 Tracy Kelly, Owen Selden, Dazhanae Houston, Derek Meyers, Brenna Kent, Aimable Kanyamuhunga, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.