Title: An innovative approach to jump start simplified management of sick young infants with PSBI where referral is not possible for potential scale-up.

Funder/ Sponsor: ICMR

Objective: This study is ongoing in Manchar area, KEMHRC. The purpose of this work is to inform and accelerate the use of simplified management of sick young infants (i.e. infants less than two months of age) up to two months of age with possible serious bacterial infection (PSBI) for eventual scale up at country level.Infections including pneumonia, sepsis and meningitis in infants below two months of age (young infants) caused over 640,000 deaths in 2013. The World Health Organization (WHO) has proposed a classification of “possible serious bacterial infection” (PSBI) for infants 0-59 days of age who have fever, low body temperature, fast breathing, severe chest indrawing, not feeding well, convulsions, and no spontaneous movements. An estimated 6.9 million episodes of PSBI occurred in 2012. As these children are at high risk of mortality, WHO recommends hospitalization and treatment with injectable antibiotics for at least 7-10 days. In many low resource settings such inpatient care is neither feasible nor acceptable for many families. A few descriptive studies have reported management of sick neonates or young infants with simple antibiotic regimens at community or first level health facility where referral was not possible. Their results show that when hospitalization is not possible, the management of serious infections in young infants can be significantly simplified and effectively delivered near their homes and guidelines for these have been developed. The proposed implementation research projects aims to demonstrate a feasible and scalable simplified intervention to manage sepsis in young infants. Ultimately the project will generate valuable evidence regarding feasibility and effectiveness of managing PSBI in young infants when referrals are not possible.

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