Training and educational needs for paediatric snakebite management among rural healthcare providers in Sri Lanka

This mixed-method study aimed to explore the educational and training needs of healthcare providers managing paediatric snakebites in regions with high burdens of snakebite envenomation in rural Sri Lanka. The goal was to identify gaps in current training practices and propose strategies to improve the clinical management of paediatric snakebite cases. A focus group discussion (FGD)-based approach was utilized to gather insights from healthcare providers involved in the management of paediatric snakebites. Participants included medical officers working in paediatric wards, paediatric emergency treatment units, paediatric intensive care units, as well as paediatric house officers and relief house officers. Using purposive sampling, participants were recruited from both tertiary referral centers and peripheral hospitals. Data were collected through six semi-structured FGDs, which were audio-recorded and transcribed. Thematic analysis was conducted following Braun and Clarke's six-step framework. The findings revealed significant gaps in knowledge and training related to paediatric snakebite management, particularly in more peripheral rural hospitals. Participants reported a lack of structured training, standardized institutional protocols, and exposure to paediatric-specific guidelines. Inconsistent knowledge among healthcare providers, particularly in peripheral settings, contributed to inappropriate treatments and delayed referrals. Recommendations for addressing these gaps included simulation-based training, mentorship programs, and standardized treatment protocols, particularly for junior doctors in resource-limited areas. The study highlights critical deficiencies in paediatric snakebite management training in rural Sri Lanka. To improve patient outcomes, there is a need for enhanced training programs, including hands-on experience, mentorship, and telemedicine support. Standardized, evidence-based guidelines should be disseminated and integrated into healthcare practices across all levels of the healthcare system.