Introduction & implementation of Possible Serious Bacterial Infection (PSBI) management in young infants up to 2 months of age when referral is not feasible

PPHI Sindh in collaboration with Aga Khan University has conducted a pilot study on PSBI in district Thatta to demonstrate feasibility of delivering simplified antibiotic regimens to young infants with PSBI where referral is not possible. The aim of this innovative approach is to demonstrate that following targets can be achieved in the demonstration sites:


Government of Sindh adapted the WHO guideline to allow management of PSBI in young infants when referral to a higher-level facility was not feasible in Thatta district. The experience has been quite positive and substantial number of young infants have been treated who otherwise would not have received timely therapy. Thus, many lives were saved. PPHI Sindh is now expanding this intervention to all the primary health facilities it manages in 22 districts of Sindh. The results of this implementation research were disseminated in July 2016 with all stakeholders in collaboration with AKU.

Strengthening the implementation of Integrated Management of Newborn and Child Illness (IMNCI)

After an internal evaluation by technical team members it was felt that PPHI Sindh has implemented extensive interventions on maternal health but a major gap still exists on Child Health. A need of providing proper training in IMNCI to healthcare providers (HCPs) was identified after monitoring and supervisory visits. Although, PPHI Sindh has provided necessary medicines for treating under 5-years-old children for pneumonia and diarrhoea but it was felt that the HCPs are still not assessing, classifying and treating these conditions appropriately. This resulted in irrational drug use, which also has implications for antimicrobial resistance.

World Health Organization (WHO) and Government of Sindh’s MNCH Department has trained over 17 Master Trainers employed by PPHI. These MTs have trained 670 health facility staffs from 300 BHU Plus including male and female doctors. It has improved management of sick children and their outcomes (Bhandari et al., 2012 and Rakha et al., 2013) and rational use of drugs at primary healthcare facilities and indirectly saves costs by reducing the use of medicines (Gouws et al., 2004). These facilitators further trained regional trainers by conducting four regional facilitators training. The Regional Facilitators conducted trickle-down trainings resulting in training more than 2329 HCPs in IMNCI in 97 training sessions of 24 participants per session.

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