Abstract
Fifteen years ago, United Nations world leaders defined millenium development goal 4 (MDG 4): to reduce under-5-year mortality rates by two-thirds by the year 2015. Unfortunately, only 27 of 138 developing countries are expected to achieve MDG 4. The majority of childhood deaths in these settings result from reversible causes, and developing effective pediatric emergency and critical care services could substantially reduce this mortality. The Ebola outbreak highlighted the fragility of health care systems in resource-limited settings and emphasized the urgent need for a paradigm shift in the global approach to healthcare delivery related to critical illness. This review provides an overview of pediatric critical care in resource-limited settings and outlines strategies to address challenges specific to these areas. Implementation of these tools has the potential to move us toward delivery of an adequate standard of critical care for all children globally, and ultimately decrease global child mortality in resource-limited settings.
Highlights
Fifteen years ago, world leaders convened at the Millennium Summit of the United Nations to set key goals to be achieved by 2015
This review provides an overview of pediatric critical care in resource-limited settings and outlines strategies to address challenges specific to these areas
We affirm that the concept of global justice for all persons needs to be applied to the shortage of pediatric and adult critical care services across the globe
Summary
World leaders convened at the Millennium Summit of the United Nations to set key goals to be achieved by 2015. In addition to preventative care and nutritional support, the development of effective pediatric emergency and critical care services in resource-limited countries can substantially reduce global mortality in children under 5 years [5, 6]. The Ebola outbreak that ravaged West Africa provided an example of the considerable need for better healthcare infrastructure and supportive care of critically ill patients in resource-limited settings. This is not a new revelation: natural and human-generated events, such as disasters and wars, produce acute and unpredictably large numbers of critically ill patients around the world. Improvement in the fundamentals of critical care medicine can and should be instrumental in helping make these urgently needed health care delivery shifts happen
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