Developing Clinical Practice Guidelines for Diagnosis and Management of Pediatric Conditions in Liberia

Clinical practice guidelines (CPGs) have helped improve the quality, affordability and efficiency of healthcare by synthesizing large amounts of evidence into digestible, practical recommendations for clinicians and patients. While many institutions in the US have created CPGs specifically for pediatric emergency medicine, there are a dearth of guidelines to help clinicians working in emergency departments in low-and-middle income countries(LMICs). This is true in Liberia, where no national pediatric-specific local guidelines exist to aid clinicians in clinical decision-making. Despite the recognition of the importance of brining evidence into practice in LMICs, there is minimal data guiding the actual practice of evidence-based medicine in these settings. There is also limited research on how widely providers working in emergency departments in these settings utilize existing CPGs, such as those in the World Health Handbook. This study uses a retrospective design to understand how medical providers diagnose and manage common pediatric conditions and the extent to which this process aligns to, or diverges from, existing guidelines.Notably, until 2019, there was no electronic data existed on pediatric patients seen at JFKMC. Thanks to enormous local efforts in collaboration with BostonChildren’s Hospital an electronic patient database for pediatric patients was established. There are currently over 2,500 pediatric cases recorded in the database, making it an ideal dataset for a myriad of clinical questions. This work is the first step towards developing evidence-based, nationally tailored clinical decision-making tools for Liberia and the region that are locally derived, locally-relevant and evidence based.

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