Series 2, episode 5 – In Sierra Leone, an emergency triage system is driving child mortality down: what we can learn from ‘ETAT+’ whole systems approach

Many children’s deaths could be prevented if the most sick children were identified soon after their arrival in a health facility, and were prioritized to be treated immediately.

The Emergency Triage Assessment and Treatment (ETAT) programme was ​initially designed by the World Health Organization in 2005 to drastically reduce waiting time, improve flow and access to quality protocol-driven care for children presenting to hospitals in resource-limited settings, and thereby improve pediatric care and outcomes. Many countries have since adapted it for implementation in their context; in Sierra Leone, it is implemented as ETAT+.

ETAT+ whole systems approach has become an integral component of Sierra Leone’s efforts to improve the quality of pediatric care.  In district hospitals implementing the programme, the proportion of children who died after arrival in hospital dropped by nearly 40%. The programme’s lessons are now being applied to other areas of care, with a similar initiative being implemented for obstetric care (obstetric ETAT).

In this episode, Dr. James Bunn, Child Health Specialist at the World Health Organization in Sierra Leone explains the changes that ETAT+ has brought about through improving patient flow, task shifting, and responding to bottlenecks which delay treatment. This has been implemented through new on-the job training methods including mentoring. He describes how improving quality of care can be possible even in facilities with scarce resources.

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