Rethinking Paediatric Sepsis Care through Local Provider Voices and Lived Systems: A Mixed-Methods Study in Two...

Area of Science:

• Global Health
• Paediatric Infectious Diseases
• Health Systems Research

Background:

• Paediatric sepsis is a leading cause of mortality in low- and middle-income countries (LMICs).
• Existing global sepsis protocols, effective in high-income settings, may not be suitable for resource-constrained LMIC contexts.
• Implementation challenges exist for standardized sepsis bundles in resource-limited settings.

Purpose of the Study:

• To investigate the factors influencing paediatric sepsis care in Ghana.
• To identify barriers and facilitators to effective sepsis management in resource-limited hospitals.
• To inform the development of contextually appropriate sepsis care strategies.

Main Methods:

• A mixed-methods study was conducted in two Ghanaian hospitals (Komfo Anokye Teaching Hospital and Presbyterian Hospital, Agogo).
• Methods included a retrospective chart review of paediatric sepsis cases and key informant interviews with clinical staff.
• Qualitative data analysis utilized the Three Delays Framework and the Donabedian Model.

Main Results:

• Seventy-one patient charts were reviewed, revealing inconsistencies in documentation and care processes.
• Despite differences in patient severity, mortality rates were similar across the two study sites.
• Interviews highlighted provider dedication and community support, alongside systemic delays due to financial and resource constraints.

Conclusions:

• Paediatric sepsis care in Ghana is shaped by interconnected structural, cultural, and procedural factors.
• Contextually adapted care pathways are essential for improving sepsis outcomes in resource-limited settings.
• Co-designed interventions, rather than solely imported protocols, offer a sustainable approach to strengthening health systems in LMICs.