An innovative bead necklace is revolutionising the detection and treatment of pneumonia for children living in remote areas of Kenya, saving nearly 200 lives this year,  Save the Children said ahead of World Pneumonia Day on 12 November.

This low cost solution to the biggest infectious killer for children aged under five helps to bridge a healthcare gap, offering a glimmer of hope in Turkana County, in north-western Kenya, where access to health care facilities and medical supplies are limited.

Save the Children’s "Beads by Breath" project has facilitated the diagnosis, treatment, or referral to health clinics, for 198 children suffering with pneumonia this year. Community health volunteers use beads to count and detect rapid breath intake which is an early warning sign for the disease.

Pneumonia, which can be prevented with vaccines, and easily treated with low-cost antibiotics if properly diagnosed, is one of Kenya’s leading causes of death in children under five years, killing an estimated 7,500 children under-five in 2021 – or nearly one child every hour[1].

Ekitela*, a community health volunteer from Loima sub-county, serves 64 households in his village. He explained that the biggest health problems his community is grappling with now are  fast breathing, coughing and malaria:

“Pneumonia is a very dangerous disease. It can kill a child very fast. If a child goes for four days with fast breathing, his or her condition could get worse very quickly and we can lose the child.

“I think the problem we have is that most mothers here are still giving birth at home because hospitals are located far from the villages. This is a big risk for babies and could lead to babies developing fast breathing or other diseases.”

Ekitela* and other community health workers use two distinct sets of necklace beads: one with red and black beads designed for children aged one to five years, and another featuring green and red beads for children aged up to 12 months.

The 60-bead necklaces comprise of 49 green beads and 11 red for children under one and 21 red beads and 39 black beads for children aged one to five. This is based on the respiratory rates of these age groups, as children under one exceeding 49 breaths per minute are considered to have pneumonia while 39 breaths a minute is the level for children between one and five years.

Ewoi*, 47, lives with his wife and five children in Turkana. Ewoi* is the primary breadwinner for the family and his livestock is the only source of livelihood for his family. However, recent back-to-back droughts have decimated his herd of 150 goats and sheep, leaving only five goats. He told Save the Children that the five goats hardly produce any milk for his children and would not fetch a good price if he were to sell them.

Coupled with this, Ewoi’s two-month-old daughter, Akiru*, was diagnosed with pneumonia in October after Ewoi rushed her to the community health volunteer with a cold and a wheezing chest.

“The illness that started as a cold worsened until the child was admitted in the referral hospital. She has been sick for six weeks,” Ewoi said.“The child had a cold, and I could hear a sound coming from her chest while breathing. She was not breastfeeding well either. I could tell my daughter was not well.”

Akiru* is now recovering at home and proof that simple, low-cost interventions such as a bead necklace can make a huge difference for children.

Save the Children’s Country Director for Kenya and Madagascar, Yvonne Arunga, said:

“Many children in Kenya and around the world are facing increased risks from the biggest infectious killer for children: pneumonia. Yet, we have the vaccine, low-cost antibiotics and simple innovations such as the bead necklace to make sure no child dies from preventable diseases such as pneumonia.

“Every child deserves a healthy start in life. Policymakers should take deliberate and targeted actions to ensure that children not only survive beyond their fifth birthdays but thrive and reach their full potential. With the right policies and adequate funding, we can initiate solutions that will change the course of history and save the lives of millions of children.”

In 2016, Save the Children launched the “Beads by Breath” project with partners and the Kenyan government to help tackle pneumonia by training community health volunteers, most of whom lack basic education, to screen for fast breathing among children.

Save the Children has trained and equipped nearly 250 community health volunteers with skills to screen and provide critical care to children under five. These volunteers have been hailed as "village doctors" by the community and have gained the trust of local mothers, who rely on them whenever their children appear ill. Additionally, they conduct regular home visits to screen children for malnutrition, pneumonia, and to provide treatment for malaria and diarrheal diseases.

Save the Children has been providing support to children in Kenya since 1950. The aid agency works with communities, local partners, and the government to design and deliver programmes to meet the needs of the most deprived children. Save the Children operates programmes in health and nutrition, food security and livelihoods, child protection, child rights governance, education, and adolescent rights.