Community and caregivers’ perceptions of pneumonia and care‐seeking experiences in Nigeria: A qualitative study

Bakare, Ayobami A; Graham, Hamish; Agwai, Imaria; Shittu, Funmilayo; King, Carina; Colbourn, Tim; Iuliano, Agnese; Aranda, Zeus; McCollum, Eric D.; Isah, Adamu; Bahiru, Solomon; Valentine, Paula; Falade, Adegoke G; Burgess, Rochelle

doi:10.1002/ppul.24620

Cited by 21 publications

(35 citation statements)

References 25 publications

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“…Some mothers, fathers and other caregivers associated pneumonia with exposure to cold environment/air. A similar finding have been noted in qualitative studies conducted in Ghana and Nigeria [25,26]. While illness conceptualization play an important role in the decision regarding treatment options [27,28], knowledge of biomedical causes alone may not lead to healthcare-seeking from facilities in settings where traditional beliefs are pervasive [29,30].…”

Section: Discussionsupporting

confidence: 77%

Exploring communities’ perceptions of the etiology of illnesses in newborns and young infants 0–59 days old in 4 counties in Kenya

et al. 2020

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Background Understanding communities’ beliefs about the causes of illnesses in sick young infants (SYIs) is key to strengthening interventions and improving newborn health outcomes. This study explored communities' perception of the etiology of illnesses in SYIs 0–59 days old in four counties in Kenya. Methods We used an exploratory qualitative study design. Data were collected between August and September 2018 and involved 23 in-depth interviews with female caregivers aged 15-24years; 25 focus group discussions with female caregivers aged 15–18 years, 19–24 years and 25–45 years; and 7 focus group discussions with fathers aged 18–34 years and 35 or more years. Participants were purposely sampled, only those with SYIs 0–59 days old were eligible to participate. Data were analyzed using inductive thematic analysis framework approach. Results Female caregivers and fathers attributed illnesses in SYIs 0–59 days old to natural (biomedical) and supernatural causes which sometimes co-existed. There were commonalities in perceived natural causes of illness in SYIs across sites, age groups and gender. Perceived natural causes of illness in SYIs include unfavorable environmental and hygiene conditions, poor maternal and child nutrition, and healthcare practices. Perceived supernatural causes of illness in SYIs such as ‘evil eyes’ were common across the four counties while others were geographically unique such as the belief that owls cause illnesses. Conclusion Communities’ understanding of the etiology of illnesses in SYIs in the study settings overlapped between natural and supernatural causes. There is need for child health programmes to take into consideration communities’ beliefs and practices regarding disease and health to improve newborn health outcomes.

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Section: Discussionsupporting

confidence: 77%

Exploring communities’ perceptions of the etiology of illnesses in newborns and young infants 0–59 days old in 4 counties in Kenya

et al. 2020

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“…However, some caregivers who were conversant with the condition described it as critical. The authors revealed that inadequate knowledge of pneumonia in the study hints at poor healthcare seeking for the illness (Bakare et al, 2020). Another study among caregivers in rural and urban communities in Kaduna found their level of awareness to be high, and misconceptions about the causes of pneumonia were also high (67%).…”

Section: Knowledge Of the Primary Caregivers (Mothers Of Under-five Children) About Iccm Conditionsmentioning

confidence: 92%

“…Predictably, variations exist in the level of knowledge for each iCCM condition among different categories of caregivers in different social settings. A systematic review of publications on iCCM conditions across developing countries revealed that the caregivers' understanding of pneumonia-specific signs and symptoms was comparatively lower than that of malaria and diarrhea (Bakare et al, 2020;Geldsetzer et al, 2014).…”

Section: Knowledge Of the Primary Caregivers (Mothers Of Under-five Children) About Iccm Conditionsmentioning

confidence: 99%

The Deadly Trio of Malaria, Pneumonia and Diarrhea: Assessing Community Knowledge Gaps and Beliefs within Integrated Community Case Management (iCCM) Practice in a Nigerian State

Amzat

Shehu

2020

NJSA

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The trio of Integrated Community Case Management (iCCM) target conditions, malaria, pneumonia and diarrhea, constitute a devastating global disease burden killing over 1 million under-5 children annually. Nigeria accounts for almost 15% of global under-5 mortality. The World Health Organization is promoting iCCM in resource-constrained societies. Therefore, this study assesses the knowledge of community members on iCCM target conditions. Health belief model serves as a theoretical guide for the study, which was conducted in three purposively selected Local Government Areas in Sokoto State, Nigeria. The study found that there are still some significant misconceptions despite the high prevalence of these diseases. About one-quarter of the respondents did not believe any of the diseases could kill a child. Socio-demographic variables have a significant effect on the knowledge gaps constituting barriers to the uptake of iCCM services. Despite the high usage of insecticide-treated bed-net, 68.9% of the respondents disclosed perceived malaria within the last 30 days preceding the survey. In all, 85.4% of the respondents have some religious barriers to attending health facilities. The study concluded that the diseases’ misconceptions limit the uptake of iCCM services where available. Therefore, knowledge of community members on iCCM needs to be improved.

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“…Maternal and child health services are provided free at selected facilities, but out of pocket costs still pose a nancial barrier to access. [4] Kiyawa LGA was selected through discussion between Save the Children Nigeria, the State Ministry of Health (SMOH) and the Jigawa State Government, using pre-de ned criteria (e.g. mortality burden, road access).…”

Section: Settingmentioning

confidence: 99%

“…vaccine coverage and clean cooking) [3] and multiple misconceptions. [4] Diverse stakeholders prioritised the strengthening of primary care and community knowledge to tackle pneumonia in the context of Jigawa State. [5] Several community-based participatory empowerment approaches for improving maternal, neonatal and child health outcomes have been trialled.…”

Section: Introductionmentioning

confidence: 99%

Integrated Sustainable Childhood Pneumonia and Infectious Disease Reduction in Nigeria (INSPIRING) Through Whole System Strengthening in Jigawa, Nigeria: Study Protocol For a Cluster Randomised Controlled Trial

King¹,

Burgess²,

Bakare³

et al. 2021

Preprint

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BackgroundChild mortality remains unacceptably high, with Northern Nigeria reporting some of the highest rates globally (e.g. 192/1000 live births in Jigawa State). Coverage of key protect and prevent interventions, such as vaccination and clean cooking fuel use, are low. Additionally, knowledge, care-seeking and health system factors are poor. Therefore, a whole systems approach is needed for sustainable reductions in child mortality.MethodsThis is a cluster randomised controlled trial, with integrated process and economic evaluations, conducted from January 2021 – September 2022. The trial will be conducted in Kiyawa Local Government Area, Jigawa State, Nigeria, with an estimated population of 230,000. Clusters are defined as primary government health facility catchment areas (n=33). The 33 clusters will be randomly allocated (1:1) in a public ceremony, and 32 clusters included in the impact evaluation. The trial will evaluate a locally adapted ‘whole systems strengthening’ package of three evidence-based methods: community men’s and women’s groups; Partnership Defined Quality Scorecard; healthcare worker training, mentorship and provision of basic essential equipment and commodities. The primary outcome is mortality of children aged 7 days to 59 months. Mortality will be recorded prospectively using a cohort design, and secondary outcomes measured through baseline and endline cross-sectional surveys. Assuming the following, we will have a minimum detectable effect size of 30%: a) baseline mortality of 100 per 1000 livebirths; b) 4,480 compounds with 3 eligible children per compound; c) 80% power; d) 5% significance; e) intra-cluster correlation of 0.007; f) coefficient of variance of cluster size of 0.74. Analysis will be by intention-to-treat, comparing intervention and control clusters, adjusting for compound and trial clustering. DiscussionThis study will provide robust evidence of the effectiveness and cost-effectiveness of community-based participatory learning and action, with integrated health system strengthening and accountability mechanisms, to reduce child mortality. The ethnographic process evaluation will allow for a rich understanding of how the intervention works in this context. However, we encountered a key challenge in calculating the sample size, given the lack of timely and reliable mortality data, and the uncertain impacts of the COVID-19 pandemic. Trial registrationISRCTN 39213655, registered 11th December 2019

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Community and caregivers’ perceptions of pneumonia and care‐seeking experiences in Nigeria: A qualitative study

Cited by 21 publications

References 25 publications

Exploring communities’ perceptions of the etiology of illnesses in newborns and young infants 0–59 days old in 4 counties in Kenya

Exploring communities’ perceptions of the etiology of illnesses in newborns and young infants 0–59 days old in 4 counties in Kenya

The Deadly Trio of Malaria, Pneumonia and Diarrhea: Assessing Community Knowledge Gaps and Beliefs within Integrated Community Case Management (iCCM) Practice in a Nigerian State

Integrated Sustainable Childhood Pneumonia and Infectious Disease Reduction in Nigeria (INSPIRING) Through Whole System Strengthening in Jigawa, Nigeria: Study Protocol For a Cluster Randomised Controlled Trial

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