A mixed-methods evaluation of stakeholder perspectives on pediatric pneumonia in Nigeria-priorities, challenges, and champions
A mixed-methods evaluation of stakeholder perspectives on pediatric pneumonia in Nigeria-priorities, challenges, and champions
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DOI：
10.1002/ppul.24607
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发表时间：
2020-01-27
影响因子：
3.1
通讯作者：
Falade, Adegoke G.
中科院分区：
文献类型：
--
作者：
King, Carina;Iuliano, Agnese;Falade, Adegoke G.
存在降低肺炎死亡率的干预措施;然而，需要利益相关者的参与来优先考虑这些措施。我们探讨了不同利益相关者对尼日利亚儿科肺炎当前政策挑战和优先事项的意见。方法我们进行了一项混合方法的研究，通过网络调查和半结构化访谈，探讨利益相关者的角色，政策障碍，机会和优先事项。网络调查参与者是通过利益攸关方分布图确定的，包括研究人员网络、学术和灰色文献以及“每一次呼吸都很重要”联盟成员。利益相关者包括参与尼日利亚儿科肺炎的非政府、政府、学术、民间社会、私人和专业组织的参与者。在拉各斯和吉川州，与当地政府、医疗保健管理人员、专业协会和当地领导人进行了利益相关者访谈。定量数据进行了分析，定性数据进行了分析，使用主题框架。结果在111名利益相关者中，38名（34%）参与了网络调查，18名利益相关者进行了访谈。提出了四个专题领域：现行政策、系统障碍、干预优先事项和倡导者。受访者报告说，尽管承认在他们的环境中通过了指导方针，但缺乏针对肺炎的政策。从社区到医疗保健再到政策，在系统的各个层面都存在有效肺炎管理的障碍，关键问题是资源和基础设施。干预的优先事项是加强社区知识和改善病例管理，重点是初级保健。虽然利益相关者确定了儿科肺炎的几个关键行为者，但他们也强调缺乏冠军。结论：出现了一致的信息，优先考虑社区和初级保健计划，同时改善氧气的获取和脉搏血氧饱和度。有必要制定明确的肺炎政策，并支持在州一级采用。
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.