Developing Pediatric Critical Care in Kenya*

Objective: To describe efforts to improve the care of critically ill children in a tertiary care public hospital in a resource-limited setting. Design: Descriptive. Setting: Pediatric wards at the Kenyatta National Hospital in Nairobi, Kenya. Patients: Critically ill children admitted to the hospital. Interventions: A graduated approach to improving critical care capacity in a resource-limited setting. Measurements and Main Results: Pediatric mortality was tracked in the adult ICU and PICU following the engagement of a pediatric intensivist and creation of a critical care team. Mortality declined from 76.2% to 37.5% in the first 2 years of the new PICU. Conclusions: Caring for critically ill children in resource-limited setting presents many challenges. The stepwise approach described here has led to a nearly 50% reduction in mortality among critically ill children at Kenyatta National Hospital. It is a viable strategy to begin to address the disproportionate number of critically ill and injured children in resource-limited setting.