Global Health Foundation Reevaluates its Pneumonia Diagnostic Strategy

Situation Analysis:

There are more than 150 million episodes of pneumonia each year in children under 5, resulting in nearly 1 million deaths, making it the leading cause of death in children worldwide. Reducing pneumonia related childhood deaths is a global priority.  Currently, only 54 percent of children with pneumonia are taken to qualified healthcare providers and even fewer receive appropriate treatment. Linking children to accurate diagnostics and life-saving treatments is expected to significantly reduce pneumonia-related deaths. Pulse oximeters are low-cost devices expected to improve pneumonia diagnoses through the accurate identification of children needing oxygen, a life-saving treatment. SDG’s global health arm, Applied Strategies, provided significant analytical insight that informed decisions for how best to develop and deliver pulse oximeters to five high-disease-burden countries.

Discovery & Solutions:

We conducted an extensive literature review and leveraged work by our clients’ partners on similar products to develop pulse oximeter product profiles. Many experts, ranging from partners at UNICEF and the World Health Organization to academicians and practicing clinicians, helped refine these profiles. Based on the product profiles, several pulse oximeters were prioritized and interviews were conducted with their manufacturers to understand potential supply capacity, expected device and probe durability, and potential product improvements. We then developed methodology, models, and data to forecast demand in two different settings: frontline community healthcare workers (CHWs) and primary healthcare facilities (PHFs).

Results and Impact:

Device demand is dependent on test demand, so we determined where caregivers seek care for children with respiratory infections. Unfortunately, few caregivers seek care from CHWs (3-8 percent) and 25-66 percent of caregivers do not seek care at all. Up to 35 percent do seek care at PHFs, and up to 65 percent seek care from other providers such as hospitals and pharmacies.  The forecast determined that approximately 200,000 handheld devices and 550,000 probes were required to meet annual pulse oximeter demand for CHWs and PHFs through 2025, with 85 percent of the demand coming from CHWs (each CHW provided one pulse oximeter) compared to 15 percent in PHFs.  Low care-seeking with CHWs coupled with high device demand led to very low device utilization (1-2 percent).  Therefore, delivering pulse oximeters to CHWs is not expected to be cost-effective or have a material impact on pneumonia death prevention. Based on the study insights, the client is reassessing its pneumonia strategy to optimize their pulse oximeter investment and impact.