A practical guide to expand integrated paediatric primary care: the PACK Child development process




Short oral session 7: Tools to communicate and use evidence


Thursday 14 September 2017 - 14:00 to 15:30


All authors in correct order:

Picken S1, Hannington J1, Fairall L1, Cornick R1
1 Knowledge Translation Unit (KTU), University of Cape Town, South Africa
Presenting author and contact person

Presenting author:

Sandy Picken

Contact person:

Abstract text
Background: With revolutionary strategies like the World Health Organization’s Integrated Management of Childhood Illness (IMCI) and the advent of interventions like the rotavirus and pneumococcal vaccines, the burden of childhood disease is shifting with mortality from infectious causes declining. This prompts the need to focus on other contributors to childhood morbidity and mortality like long-term health conditions, along with the need for improved integration of curative and preventive services that consider the well child. Furthermore, with the existing emphasis on the child under five, space exists to address the older child.

Objectives: In response to evolving child health needs, the Knowledge Translation Unit (KTU) set out to develop a comprehensive guide to expand integrated paediatric primary care.

Methods: Overseen by a Guideline Development Advisory Group and with the aid of independent funding and policy-maker support, the KTU spent 2 years developing PACK Child. Initial draft clinical content was constructed using international guidelines and synthesised evidence products, which was then adapted to reflect local policies as well as medication and resource limitations. It then endured rigorous iterations of multidisciplinary consultation, piloting, expanding and refining in order to finalise and integrate the content.

Results: PACK Child is a 136-page, evidence-informed, policy-aligned guide, for use during a primary care consultation with a child aged 0-13 years. Using simple features, like red boxes indicating urgency, easy-to-follow algorithms and a standardised format, it provides a practical approach to 63 symptoms and 16 priority, long-term health conditions and integrates routine care into every visit.

Conclusions: The PACK Child guide development process has not only resulted in a comprehensive, integrated guide that addresses changing child health needs, but has also led to several health systems improvements like clarification of prescriber levels, scope of practice and referral pathways, and improving access to medication.