Why Kenya should strengthen paediatric critical care

 Infant and child mortality

Every parent hopes their child will grow up healthy and strong. When illness strikes, what matters most is timely access to the right care. For children who become critically ill, survival depends not only on medical expertise but on systems designed specifically to meet their unique needs. Strengthening paediatric critical care is therefore a crucial part of Kenya’s efforts to reduce infant and child mortality.

Kenya has made notable progress in child survival over the years. However, a sobering reality remains: nearly 70 percent of child deaths are still caused by preventable or treatable conditions such as pneumonia, diarrhoea, malaria, malnutrition, and anaemia. According to UNICEF, the under-five mortality rate in Kenya stands at approximately 39.9 deaths per 100 live births. These are not merely statistics, but children whose lives could often be saved with timely, specialized care.

Putting in place mechanisms to save our young ones is a noble course and assurance for our country’s survival. These mechanisms are crucial to ongoing efforts to strengthen the healthcare system. Today, many hospitals are working around the clock to modernise their Paediatric Intensive Care Units (PICUs) in a bid to reduce mortality rates among young children. Evidence of a steady growth of instances requiring intensive care means more needs to be done to address emerging needs in critical healthcare.

Prevention remains vital and must continue through immunization, nutrition, sanitation, and health education. Yet even with strong prevention strategies, some children will become critically ill. Severe infections, birth complications, trauma, and sudden deterioration can overwhelm a child’s fragile physiology within hours. In such moments, access to high-quality paediatric emergency and intensive care can determine not only survival, but the quality of recovery. Pediatric critical care is not simply adult intensive care scaled down.

Children have unique physiological and emotional needs. A functional PICU depends on trained paediatric specialists, skilled nurses, child-appropriate equipment, and multidisciplinary teamwork. It is a system built on preparation and precision, not improvisation. When a child is critically ill, minutes matter, but so does teamwork. Effective paediatric critical care relies on seamless coordination between emergency services, pediatricians, intensivists, nurses, laboratory teams, and imaging services. Strong referral networks and timely transfers are equally critical.

Survival alone is not the only outcome that matters. Many children recovering from critical illness experience prolonged weakness, fatigue, anxiety, sleep disturbances, or difficulties returning to school. Some develop fear or emotional distress related to their hospital experience. These challenges highlight the importance of paediatric critical care systems that incorporate rehabilitation, psychological support, and family-centered care.

Injuries further add to the burden. UNICEF reports that globally, more than 1,600 children and adolescents under 19 die every day from preventable injuries such as road crashes, drowning, burns, falls, and poisoning.

Every healthcare establishment needs to be fully equipped with modern pulse oximeters, infusion pumps, pediatric airway kits, and appropriately sized masks and tubes to adequately serve the rising needs of pediatric care. Beyond equipping hospitals and healthcare establishments, ambulances and first responder vehicles need to be fully equipped for children. This will make it possible to address critical care needs while in transit or at the scene of first contact.

Dr. Rohini is a paediatrician and pediatric intensive care specialist at The Nairobi Hospital