Looking at the WHO roadmap (which deals with bacterial meningitis collectively in children and adults, and with different pathogens) Isee
EXTRACTS
Strategic Goal 6: Improve diagnosis of meningitis at all levels of care:
Develop and disseminate regionally specific policies on testing requirements and tools for each level of the health system, according to the required decisionmaking (for example, for immediate clinical management, epidemic response, antimicrobial resistance)...
Establish appropriate training and supervision of health workers at each level of care for timely identification, diagnosis, referral and treatment of meningitis in all age groups. [curiously this was the last ecommended activity - I would have put it at the top, together with meeting the information needs of parents]
Strategic Goal 8: Develop and implement a contextspecific policy to identify mothers who are GBS carriers, and for diagnosis of infant GBS infection, particularly for lowresource settings [indeed this was probably the basis for the later WHO guidance on screening that we have discussed]
COMMENT (NPW): I get the impression that specific guidance related to Group B Strep and periinatal infections is perhaps missing in this roadmap? Is there a need for the derivation of a specific roadmap for Group B Strep, which would buildon the collective roadmap?
On the issue of 'Improve diagnosis of [Group B Strep] meningitis at all levels of care' we need to know a lot more about this. What is the current level of care for mothers and infants in relation to Group B Strep? What do health workers know about its prevention and treatment? Are they able to adequately and reliably identify early signs of sepsis and meningitis in infants? Is appropriate treatment initiated without delay. Do health workers have access to diagnostic support? In general, are health workers empowered by the health system with their basic SEISMIC needs? www.hifa.org/needs
I invite your comments on quality of care available in different settings.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org