Abstract
BackgroundAn understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries. This study therefore elicited the views of paediatricians on current global priorities for newborn health in Nigeria as possible guide for policy makers.MethodsPaediatric consultants and residents in the country were surveyed nationally between February and March 2011 using a questionnaire requiring the ranking of nine prominent and other neonatal conditions based separately on hospital admissions, mortality, morbidity and disability as well as based on all health indices in order of importance or disease burden. Responses were analysed with Friedman test and differences between subgroups of respondents with Mann-Whitney U test.ResultsValid responses were received from 152 (65.8%) of 231 eligible physicians. Preterm birth/low birthweight ranked highest by all measures except for birth asphyxia which ranked highest for disability. Neonatal jaundice ranked next to sepsis by all measures except for disability and above tetanus except mortality. Preterm birth/low birthweight, birth asphyxia, sepsis, jaundice and meningitis ranked highest by composite measures while jaundice had comparable rating with sepsis. Birth trauma was most frequently cited under other unspecified conditions. There were no significant differences in ranking between consultants and residents except for birth asphyxia in relation to hospital admissions and morbidity as well as sepsis and tetanus in relation to mortality.ConclusionsCurrent global priorities for neonatal survival in Nigeria largely accord with paediatricians’ views except for neonatal jaundice which is commonly subsumed under “other“ or "miscellaneous" neonatal conditions. While the importance of these priority conditions extends beyond mortality thus suggesting the need for a broader conceptualisation of newborn health to reflect the current realities, paediatricians should be actively engaged in advancing the attainment of global priorities for child survival and health in this population.
Highlights
An understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries
Despite declining under-5 mortality rates worldwide, recent global estimates still suggest that about 8.8million children die every year out of which 41% occur in the neonatal period compared with 37% a decade ago [1]
While neonatal mortality in Nigeria declined from 53 to 39 per 1000 live births in the last decade, the country still accounts for 8.3% of global neonatal deaths
Summary
An understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries. This study elicited the views of paediatricians on current global priorities for newborn health in Nigeria as possible guide for policy makers. Complications of preterm birth, birth asphyxia, infections, diarrhoea, tetanus and congenital abnormalities have been extensively reported as the leading causes of neonatal deaths for which priority investment is urgently required to build requisite national capacity to effectively address these conditions [1]. Besides the prevailing concerns about the slow pace of progress on mortality reduction in some developing countries, morbidity and disability are gaining recognition as important indices of newborn health especially within the context of the expanding populations of child survivors [3,4].
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