• Rashmi Kumar and Michael F Canarie.
• Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
• Pediatr Crit Care Me. 2019 Dec 1; 20 (12): e538-e545.

ObjectiveTo describe efforts to improve the care of critically ill children in a tertiary care public hospital in a resource-limited setting.DesignDescriptive.SettingPediatric wards at the Kenyatta National Hospital in Nairobi, Kenya.PatientsCritically ill children admitted to the hospital.InterventionsA graduated approach to improving critical care capacity in a resource-limited setting.Measurements And Main ResultsPediatric mortality was tracked in the adult ICU and PICU following the engagement of a pediatric intensivist and creation of a critical care team. Mortality declined from 76.2% to 37.5% in the first 2 years of the new PICU.ConclusionsCaring for critically ill children in resource-limited setting presents many challenges. The stepwise approach described here has led to a nearly 50% reduction in mortality among critically ill children at Kenyatta National Hospital. It is a viable strategy to begin to address the disproportionate number of critically ill and injured children in resource-limited setting.

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