PDMC Implementation Trial in Kenya

Inclusion Criteria: 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 Exclusion Criteria: 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.