Children's Automated Respiration Monitor (ChARM) for Child Pneumonia Diagnosis by Community Health Workers in Mali: Innovating ChARM's Role in Supervision, Training and Diagnosis

In Mali, a country with remote populations and threats to stability, access to accurate diagnosis, treatment and appropriate referral determines a child's survival. In 2007, the Mali Ministry of Health (MMoH) introduced Integrated Community Case Management, authorizing community health workers (CHWs) to diagnose and treat pneumonia, malaria, diarrhea and malnutrition in children under five. In 2013 Mali reported 231,548 pneumonia cases, and only 20% were treated by CHWs. Increasing the quality of CHWs’ diagnostic skills is challenged by inadequate funding. Poor CHW competency to correctly count respiratory breaths, a key MMoH ICCM indicator for pneumonia detection, puts them at risk to frequently misdiagnose pneumonia and overprescribe antibiotics. Royal Philips’ 2015 pledge to Every Woman, Every Child includes improved pneumonia diagnosis and treatment in low resource countries. This project uses Philips’ Children’s Automated Respiratory Monitor (ChARM) to minimize the risk of pneumonia misdiagnosis and use as a teaching tool so CHWs can evaluate their breath counting skills against ChARM’s automated readings. A randomized cluster trial to evaluate ChARM’s potential to improve the quality of diagnosis and use as a teaching tool, will be particularly valuable in fragile settings. The project is embedded in a 2016-2020 health program with the MMoH, the Malian and Canadian Red Cross Societies, and the Hospital for Sick Children. The embedded nature reduces project costs.