Spina Bifida Care In Kenya Through A Network Of Mobile Clinics

Abstract

Background: Children with spina bifida require ongoing multidisciplinary care in order to prevent complications and improve quality of life. Bethany Crippled Children's Centre of Kenya and BethanyKids at Kijabe Hospital have been providing such care for spina bifida patients through a network of mobile clinics throughout Kenya. The purpose of this report is to present the mobile clinic network and the way it has impacted the care of children with spina bifida.
Patients and Methods: The medical records of all infants with spina bifida treated at AIC Kijabe Hospital and its “daughter” institution BCCCK between January 1998 and October 2004 were reviewed. Information on the mobile clinics and the number of patients (new and follow up) seen there was also collected.
Results: The review included 501 patients, seen over the past 6 years in 22 clinics, of which 10 are still operational. Of the 501 children, 215 children were not seen since December 2003. Twenty children were discharged from follow-up. Of the 185 children seen alive after December 2003, 128 reported doing well, 21 were doing fairly well and 16 were not doing well. Out of the 501 children 94 are known to have died since 1998.
Conclusions: Many children with spina bifida in this study appear to be doing well after the closure of the defect. A multi-disciplinary, integrated program with frequent follow-up is essential to improving the quality of life of these children. The mobile clinic network allows follow-up at regular intervals, reduces travel costs for the patient, optimises the human resources, utilizes local resources, provides education and creates communities of parents of children with similar conditions.


Keywords: Spina bifida, Multidisciplinary Care, Network Clinic

African Journal of Paediatric Surgery Vol. 3 (1) 2006: pp. 13-18