PDMC Implementation Trial in Kenya

Who May Qualify: CLUSTERS - Health facilities with blood transfusion services offering in-patient care for children with severe anaemia and severe malaria. - \>=40 children per year admitted with severe anaemia or severe malaria - Agreement to participate by facility management - Located in areas with moderate to high malaria transmission INDIVIDUAL PARTICIPANTS - Aged \<10 years of both sexes - Hospitalised with severe anaemia or severe malaria: Initially hospitalised with haemoglobin \<5.0 g/dl or PCV \<15%, or requirement for blood transfusion for other clinical reasons on or during admission to the hospital, or severe malaria, defined as a requirement for parenteral artesunate in the opinion of the treating clinician and/or the presence of microscopy or RDT confirmed Plasmodium infection Who Should NOT Join This Trial: CLUSTERS \- Health facilities without subservient lower-level health facilities INDIVIDUAL PARTICIPANTS - Recognised specific other causes of severe anaemia (i.e., trauma, haematological malignancy, known bleeding disorders, such as haemophilia) - Sickle cell anaemia/sickle cell disease - Body weight \<5 kg - HIV infection and cotrimoxazole prophylaxis are not exclusion criteria. Always talk to your doctor about whether this trial is right for you.