The effect of staff and community education on oxygen uptake by paediatric patients in a rural hospital in Malawi

Abstract

Aims Oxygen therapy is often refused by patients in rural Southern Malawi. The aim of this study was to assess the impact of a twofold brief education intervention on the use of oxygen therapy at a rural hospital in Southern Malawi. Methods The use and uptake of oxygen was assessed by a retrospective review of paediatric case notes during the months of December 2010, January 2011 and February 2011. The results were discussed with the clinical officers and primary health care team based at Trinity Hospital. The superintendent clinical officer organised a teaching session on the use of oxygen concentrator. The primary health care team did a community education session (a talk to guardians attending outreach clinics) on oxygen at the four nearest villages during the month of March 2011. A review of notes from April, May and June then assessed the impact of the oxygen therapy. The results were analysed using Microsoft Excel 2010. Results During December, January and February there were 506 admissions of which 62 were for acute respiratory infections (ARI). 20 patients in total (4% of total) were counselled for oxygen therapy of which 15 patients had ARI, 6 of these (40%) refused oxygen, 4 (27%) died whilst on oxygen and 5 (33%) survived. During April, May, and June there were 352 admissions, of which 120 were for ARI. 53 patients in total (15% of total) were counselled for oxygen therapy of which 35 had ARI. 13 (37%) refused oxygen, 1 (3%) died on oxygen and 22 (63%) survived. Conclusion After a brief education session, clinicians and nurses were more willing to counsel patients regarding oxygen therapy. More patients are given oxygen therapy and more survive with oxygen therapy. Community education by the primary health care team had no effect on changing the opinions of patients and guardians as to whether or not they would accept oxygen therapy. Further research is needed into why patients refuse oxygen therapy.