Responding to numerous requests for a comprehensive guide for children, the Knowledge Translation Unit has developed the first version of PACK Child. Using familiar design features from PACK Adult, it is designed to equip nurses and doctors to diagnose and manage common childhood conditions, ages 0–13 years, at primary care level. The guide emphasises the integration of routine care of the child into every visit and integrates important themes like the First 1000 days initiative.
PACK Child development was funded by The Children’s Hospital Trust and the KTU is working closely with the Western Cape Department of Health to ensure that content speaks to provincial policy and health system realities.
The PACK Child development process (1) was a consultative one and involved numerous multidisciplinary clinical working groups of paediatricians, family physicians, clinical nurse practitioners, nurses, auxiliary health care workers, Department of Health managers and other role players in public sector paediatric care, including patient advocacy groups.
PACK Child will not replace the Integrated Management of Childhood Illness (IMCI) programme but aligns with its recommendations and aims to reinforce and build on its successes and address its limitations. PACK Child will incorporate features such an approach to the well child, the child over 5 years old and the child with a long-term health condition.
PACK Child has been implemented as a pilot study in 2017/2018 in selected clinics in the catchment area of Red Cross Children’s Hospital, Cape Town, employing the usual PACK training approach of short, regular on-site sessions using case-based teaching methods. This pilot was accompanied by a thorough process evaluation (2), the results of which will inform further refinement of the programme ahead of a planned PACK Child trial to evaluate its effectiveness in everyday practice, before wider implementation.
In parallel, the KTU is working on a version of PACK Child for international use in low- and middle- income countries, aligning the recommendations with international evidence and World Health Organisation guidance and Essential Medicines Lists. Once completed, this will be made available for in-country localisation supported by KTU mentorship.
Symptom based approach
Standardised approach to long-term health conditions
Waiting Room Scene
- Picken S, Hannington J, Fairall L, et al. PACK Child: the development of a practical guide to extend the scope of integrated primary care for children and young adolescents. (Submitted to BMJ Global Health as part of PACK Collection: bmjgh-2018-000957R3) 2018.
- Murdoch J, Curran R, Bachmann M, et al. Strengthening the quality of paediatric primary care in South Africa: Protocol for process evaluation of a pilot and feasibility study of a health systems intervention. (Submitted to BMJ Global Health as part of PACK Collection: bmjgh-2018-000945) 2018.