Objective: To assess medical doctors adherence to national protocol for treatment of severe pneumonia in under-five children.Methods: A descriptive, across-sectional among medical doctors and prospective among children study was conducted in the period from 10-25 th of October 2018. Children, less than five years of age admitted and treated for severe pneumonia were enrolled. Medical doctors of consultants, registrars, medical officers and house officers in charge of treating the children were enrolled. A pre-constructed questionnaire was distributed among medical doctors and data collection sheets were filled from patient's admission sheet. The data were organized and analyzed using the SPSS version.Results: Only 80 (72%) out of 110 enrolled patients treated by medical doctors according to national pneumonia protocol. Benzylpenicillin was most single used antibiotic followed by cefotaxime while cefepime was least one majority of patients 77 (70%) were responded to treatment 65 (59%) patients' responded that prescribed according to national pneumonia protocol. There was association between adherence to national pneumonia protocol and immunization status of patient's p-value 0.001, while association was not considered significant between response and the immunization status of patients. The barriers to follow the protocol by medical doctors includes lack of awareness about protocol, mimic seniors and patient factors such as low socio-economic status of families. Conclusion:Encouraging dissemination and hospital-level implementation of the national protocol by posters, workshops and better training of healthcare providers especially the junior doctors and critical review of implementing the protocol in prescriptions.
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