UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Health system challenges for improved childhood pneumonia case management in Lagos and Jigawa, Nigeria

Shittu, F; Agwai, IC; Falade, AG; Bakare, AA; Graham, H; Iuliano, A; Aranda, Z; ... Valentine, P; + view all (2020) Health system challenges for improved childhood pneumonia case management in Lagos and Jigawa, Nigeria. Pediatric Pulmonology 10.1002/ppul.24660. (In press).

[img] Text (Article)
Colbourn_Health Systems Childhood Pneumonia Nigeria paper_R2clean.pdf - Accepted version
Access restricted to UCL open access staff until 29 January 2021.

Download (531kB)
[img] Text (Figure 1)
Colbourn_Figure 1.pdf - Accepted version
Access restricted to UCL open access staff until 29 January 2021.

Download (138kB)
[img] Text (Figure 2)
Colbourn_Figure 2.pdf - Accepted version
Access restricted to UCL open access staff until 29 January 2021.

Download (20kB)
[img] Text (Tables)
Colbourn_Tables for Health Systems Childhood Pneumonia Nigeria paper.pdf
Access restricted to UCL open access staff until 29 January 2021.

Download (379kB)
[img] Text (Supporting information)
Colbourn_ppul24660-sup-0001-web_appendix_for_health_systems_childhood_pneumonia_nigeria_paper (1).pdf - Accepted version
Access restricted to UCL open access staff until 29 January 2021.

Download (2MB)

Abstract

Background: Case fatality rates for childhood pneumonia in Nigeria remain high. There is a clear need for improved case management of pneumonia, through the sustainable implementation of the Integrated Management of Childhood Illnesses (IMCI) diagnostic and treatment algorithms. We explored barriers and opportunities for improved case management of childhood pneumonia in Lagos and Jigawa states, Nigeria. / Methods: A mixed‐method analysis was conducted to assess the current health system capacity to deliver quality care. This was done through audits of 16 facilities in Jigawa and 14 facilities in Lagos, questionnaires (n = 164) and 13 focus group discussions with providers. Field observations provided context for data analysis and triangulation. / Results: There were more private providers in Lagos (4/8 secondary facilities) and more government providers in Jigawa (4/8 primary, 3/3 secondary, and 1/1 tertiary facilities). Oxygen and pulse oximeters were available in two of three in Jigawa and six of eight in Lagos of the sampled secondary care facilities. None of the eight primary facilities surveyed in Jigawa had oxygen or pulse oximetry available while in Lagos two of three primary facilities had oxygen and one of three had pulse oximeters. Other IMCI and emergency equipment were also lacking including respiratory rate timers, particularly in Jigawa state. Health care providers scored poorly on knowledge of IMCI, though previous IMCI training was associated with better knowledge. Key enabling factors in delivering pediatric care highlighted by health care providers included accountability procedures and feedback loops, the provision of free medication for children, and philanthropic acts. Common barriers to provide care included the burden of out‐of‐pocket payments, challenges in effective communication with caregivers, delayed presentation, and lack of clear diagnosis, and case management guidelines. / Conclusion: There is an urgent need to improve how the prevention and treatment of pediatric pneumonia is directed in both Lagos and Jigawa. Priority areas for reducing pediatric pneumonia burden are training and mentoring of health care providers, community health education, and introduction of oximeters and oxygen supply.

Type: Article
Title: Health system challenges for improved childhood pneumonia case management in Lagos and Jigawa, Nigeria
DOI: 10.1002/ppul.24660
Publisher version: https://doi.org/10.1002/ppul.24660
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: health care providers, Integrated Management of Childhood Illness, management, pediatric pneumonia
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10091876
Downloads since deposit
1Download
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item