Public Health Action SHORT COMMUNICATION Paediatric in-patient care in a confl ict-torn region of Somalia: are hospital outcomes of acceptable quality?

This was a cross-sectional descriptive study using routine programme data. The study was conducted over a 2-year period (2010–2011) in Istarlin hospital, in G uriel district, Somalia, which caters for a population of 327 000. The study population included all children aged <15 years admitted to the paediatric ward. Somalia is one of the most challenging contexts for health workers, due to the risks of kidnapping and life threats. No expatriates were present, and the hospital was exclusively reliant on Somali staff. As a way of supporting these clinicians, a real-time audio-video telemedicine support service from Kenya was introduced in 2010.1 MSF started its support of the hospital in 2006; available services included paediatrics, internal medicine, maternity and emergency surgery. There were 90 beds, of which 36 were allocated to paediatrics, including neonatology. No intensive care unit was in place. There were four medical doctors and 80 nurses. There was no functional Ministry of Health, and all existing health services were provided by aid organisations and private for-profi t actors. All services were provided free of charge. Data were entered into an electronic data monitoring tool (In Patient Monitoring Tool, IPD Tool, Epicentre, Paris, France) by data entry clerks. Case defi nitions and outcomes were standardised. The database was regularly supervised and used for analysis. Data reported here included a period when telemedicine services were available (2011). This study satisfi ed the ethics criteria of the MSF Ethics Review Board and the Ethics Advisory Group of the International Union Against Tuberculosis and Lung Disease for studies using routinely collected data.