Carina King1,2, Agnese Iuliano2, Rochelle Ann Burgess2, Imaria Agwai3, Samy Ahmar4, Zeus Aranda2, Solomon Bahiru5, Ayobami A Bakare1,6, Tim Colbourn2, Funmilayo Shittu7, Hamish Graham8, Adamu Isah5, Eric D McCollum9, Adegoke G Falade10. 1. Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. 2. Institute for Global Health, University College London, London, UK. 3. Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria. 4. Save the Children UK, London, UK. 5. Save the Children International, Abuja, Nigeria. 6. Department of Community Medicine, University College Hospital, Ibadan, Nigeria. 7. Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria. 8. International Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia. 9. Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland. 10. Department of Paediatrics, University of Ibadan and University College Hospital, Ibadan, Nigeria.
Abstract
BACKGROUND: Interventions to reduce pneumonia mortality exist; however, stakeholder engagement is needed to prioritize these. We explored diverse stakeholder opinions on current policy challenges and priorities for pediatric pneumonia in Nigeria. METHODS: We conducted a mixed-methods study, with a web-survey and semi-structured interviews, to explore stakeholder roles, policy barriers, opportunities, and priorities. Web-survey participants were identified through stakeholder mapping, including researchers' networks, academic and grey literature, and "Every Breath Counts" coalition membership. Stakeholders included actors involved in pediatric pneumonia in Nigeria from non-governmental, government, academic, civil society, private, and professional organizations. Stakeholder interviews were conducted with local government, healthcare managers, professional associations, and local leaders in Lagos and Jigawa states. Quantitative data were analyzed descriptively; qualitative data were analyzed using a thematic framework. RESULTS: Of 111 stakeholders, 38 (34%) participated in the web-survey and 18 stakeholder interviews were conducted. Four thematic areas emerged: current policy, systems barriers, intervention priorities, and champions. Interviewees reported a lack of pneumonia-specific policies, despite acknowledging guidelines had been adopted in their settings. Barriers to effective pneumonia management were seen at all levels of the system, from the community to healthcare to policy, with key issues of resourcing and infrastructure. Intervention priorities were the strengthening of community knowledge and improving case management, focused on primary care. While stakeholders identified several key actors for pediatric pneumonia, they also highlighted a lack of champions. CONCLUSION: Consistent messages emerged to prioritize community and primary care initiatives, alongside improved access to oxygen, and pulse oximetry. There is a need for clear pneumonia policies, and support for adoption at a state level.
BACKGROUND: Interventions to reduce pneumonia mortality exist; however, stakeholder engagement is needed to prioritize these. We explored diverse stakeholder opinions on current policy challenges and priorities for pediatric pneumonia in Nigeria. METHODS: We conducted a mixed-methods study, with a web-survey and semi-structured interviews, to explore stakeholder roles, policy barriers, opportunities, and priorities. Web-survey participants were identified through stakeholder mapping, including researchers' networks, academic and grey literature, and "Every Breath Counts" coalition membership. Stakeholders included actors involved in pediatric pneumonia in Nigeria from non-governmental, government, academic, civil society, private, and professional organizations. Stakeholder interviews were conducted with local government, healthcare managers, professional associations, and local leaders in Lagos and Jigawa states. Quantitative data were analyzed descriptively; qualitative data were analyzed using a thematic framework. RESULTS: Of 111 stakeholders, 38 (34%) participated in the web-survey and 18 stakeholder interviews were conducted. Four thematic areas emerged: current policy, systems barriers, intervention priorities, and champions. Interviewees reported a lack of pneumonia-specific policies, despite acknowledging guidelines had been adopted in their settings. Barriers to effective pneumonia management were seen at all levels of the system, from the community to healthcare to policy, with key issues of resourcing and infrastructure. Intervention priorities were the strengthening of community knowledge and improving case management, focused on primary care. While stakeholders identified several key actors for pediatric pneumonia, they also highlighted a lack of champions. CONCLUSION: Consistent messages emerged to prioritize community and primary care initiatives, alongside improved access to oxygen, and pulse oximetry. There is a need for clear pneumonia policies, and support for adoption at a state level.
Authors: Hamish R Graham; Omotayo E Olojede; Ayobami Adebayo A Bakare; Eric D McCollum; Agnese Iuliano; Adamu Isah; Adams Osebi; Ibrahim Seriki; Tahlil Ahmed; Samy Ahmar; Christine Cassar; Paula Valentine; Temitayo Folorunso Olowookere; Matt MacCalla; Obioma Uchendu; Rochelle Ann Burgess; Timothy Colbourn; Carina King; Adegoke G Falade Journal: BMJ Open Date: 2022-05-02 Impact factor: 3.006
Authors: Carina King; Rochelle Ann Burgess; Ayobami A Bakare; Funmilayo Shittu; Julius Salako; Damola Bakare; Obioma C Uchendu; Agnese Iuliano; Adamu Isah; Osebi Adams; Ibrahim Haruna; Abdullahi Magama; Tahlil Ahmed; Samy Ahmar; Christine Cassar; Paula Valentine; Temitayo Folorunso Olowookere; Matthew MacCalla; Hamish R Graham; Eric D McCollum; Adegoke G Falade; Tim Colbourn Journal: Trials Date: 2022-01-31 Impact factor: 2.279