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Salako J, Bakare D, Uchendu OC, Bakare AA, Graham H, Falade AG. Factors associated with immunization status among children aged 12-59 months in Lagelu local government area, Ibadan: a cross-sectional study. Pan Afr Med J 2024; 47:35. [PMID: 38586066 PMCID: PMC10998252 DOI: 10.11604/pamj.2024.47.35.37013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/31/2023] [Indexed: 04/09/2024] Open
Abstract
Introduction childhood deaths from preventable causes remain high in Nigeria. Although vaccines are available to combat many of these diseases, vaccine coverage remains low in many at-risk communities. With this study, we aimed to determine factors that might have impacted the use of immunization services in Ibadan, the capital of Oyo State in southwest Nigeria. Methods we conducted a community-based cross-sectional study in a peri-urban local government area in Ibadan using a multi-stage cluster sampling technique to identify respondents for this study. The interviewer-administered questionnaire was used to obtain information on respondents and child socio-demographic details. We reviewed the child´s vaccine card to determine vaccine status. Data were analyzed using STATA version 14 at a 5% level of significance. Results of the 265 children aged 12 to 59 months who had their vaccine cards appropriately filled, only 65.3% (n=173) received all basic vaccines, while 90.2% (n=239) and 86.8% (n=230) received 3 doses of pentavalent vaccine (PENTA) and pneumococcal conjugate vaccines (PCV-10) respectively. We found a significant difference in the completion of basic vaccination according to the caregiver´s place of residence and the mother´s educational level. Access-related barriers were frequently reported (n=24, 54.5%) as reasons for missing a due vaccine. Conclusion improvement in vaccine coverage in this setting is necessary. Targeted health information for mothers may be a cost-efficient and sustainable approach to improve vaccine coverage for under-five children.
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Affiliation(s)
- Julius Salako
- Department of Health Promotion and Education, University of Ibadan, Ibadan, Nigeria
| | - Damola Bakare
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
| | - Obioma Chukwudi Uchendu
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayobami Adebayo Bakare
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Hamish Graham
- Centre for International Child Health, Murdoch Children´s Research Institute, University of Melbourne, Royal Children´s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | - Adegoke Gbadegesin Falade
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
- Department of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Iuliano A, Shittu F, Colbourn T, Salako J, Bakare D, Bakare AAA, King C, Graham H, McCollum ED, Falade AG, Uchendu O, Haruna I, Valentine P, Burgess R. Community perceptions matter: a mixed-methods study using local knowledge to define features of success for a community intervention to improve quality of care for children under-5 in Jigawa, Nigeria. BMJ Open 2023; 13:e069213. [PMID: 37973546 PMCID: PMC10660644 DOI: 10.1136/bmjopen-2022-069213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 09/22/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES In this study, we used the information generated by community members during an intervention design process to understand the features needed for a successful community participatory intervention to improve child health. DESIGN We conducted a concurrent mixed-methods study (November 2019-March 2020) to inform the design and evaluation of a community-facility linkage participatory intervention. SETTING Kiyawa Local Government Area (Jigawa State, Nigeria)-population of 230 000 (n=425 villages). PARTICIPANTS Qualitative data included 12 community conversations with caregivers of children under-5 (men, older and younger women; n=9 per group), 3 focus group discussions (n=10) with ward development committee members and interviews with facility heads (n=3). Quantitative data comprised household surveys (n=3464) with compound heads (n=1803) and women (n=1661). RESULTS We analysed qualitative data with thematic network analysis and the surveys with linear regression-results were triangulated in the interpretation phase. Participants identified the following areas of focus: community health education; facility infrastructure, equipment and staff improvements; raising funds to make these changes. Community involvement, cooperation and empowerment were recognised as a strategy to improve child health, and the presence of intermediate bodies (development committees) was deemed important to improve communication and solve problems between community and facility members. The survey showed functional community relations' dynamics, with high levels of internal cohesion (78%), efficacy in solving problems together (79%) and fairness of the local leaders (82%). CONCLUSIONS Combining the results from this study and critical theories on successful participation identified community-informed features for a contextually tailored community-facility link intervention. The need to promote a more inclusive approach to future child health interventions was highlighted. In addition to health education campaigns, the relationship between community and healthcare providers needs strengthening, and development committees were identified as an essential feature for successfully linking communities and facilities for child health. TRIAL REGISTRATION NUMBER ISRCTN39213655.
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Affiliation(s)
- Agnese Iuliano
- UCL Institute for Global Health, University College London, London, UK
| | - Funmilayo Shittu
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Timothy Colbourn
- UCL Institute for Global Health, University College London, London, UK
| | - Julius Salako
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Damola Bakare
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Ayobami Adebayo A Bakare
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | - Carina King
- UCL Institute for Global Health, University College London, London, UK
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Hamish Graham
- Centre for International Child Health, University of Melbourne, MCRI, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Eric D McCollum
- Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Adegoke G Falade
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
- Department of Paediatrics, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
| | - Obioma Uchendu
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | | | | | - Rochelle Burgess
- UCL Institute for Global Health, University College London, London, UK
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Bakare AA, King C, Salako J, Bakare D, Uchendu OC, Burgess RA, Shittu F, Iuliano A, Isah A, Ahmed T, Ahmar S, Valentine P, Olowookere TF, McCollum ED, Colbourn T, Falade AG, Graham HR. Pneumonia knowledge and care seeking behavior for children under-five years in Jigawa, Northwest Nigeria: a cross-sectional study. Front Public Health 2023; 11:1198225. [PMID: 37533532 PMCID: PMC10393027 DOI: 10.3389/fpubh.2023.1198225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/19/2023] [Indexed: 08/04/2023] Open
Abstract
Background Between 2013 and 2022, Nigeria did not meet globally defined targets for pneumonia control, despite some scale-up of vaccinations, oxygen and antibiotics. A deliberate focus on community-based programs is needed to improve coverage of protective, preventive and treatment interventions. We therefore aimed to describe caregiver knowledge and care seeking behaviour for childhood pneumonia, in a high child mortality setting in Nigeria, to inform the development of effective community-based interventions for pneumonia control. Methods We conducted a cross-sectional household survey in Kiyawa Local Government Area, Jigawa State, Nigeria between December 2019 and March 2020. We asked caregivers about their knowledge of pneumonia symptoms, prevention, risks, and treatment. A score of 1 was assigned for each correct response. We showed them videos of pneumonia specific symptoms and asked (1) if their child had any respiratory symptoms in the 2-weeks prior; (2) their subsequent care-seeking behaviour. Multivariate regressions explored socio-demographic and clinical factors associated with care seeking. Results We surveyed 1,661 eligible women, with 2,828 children under-five. Only 4.9% of women could name both cough and difficulty/fast breathing as pneumonia symptoms, and the composite knowledge scores for pneumonia prevention, risks and treatment were low. Overall, 19.0% (536/2828) of children had a report of pneumonia specific symptoms in the prior two-weeks, and of these 32.3% (176/536) were taken for care. The odds of care seeking was higher among children: with fever (AOR:2:45 [95% CI: 1.38-4.34]); from wealthiest homes (AOR: 2:13 [95% CI: 1.03-4.38]) and whose mother first married at 20-26 years compared to 15-19 years (AOR: 5.15 [95% CI: 1.38-19.26]). Notably, the caregiver's knowledge of pneumonia was not associated with care seeking. Conclusion While some socio-demographic factors were associated with care seeking for children with symptoms of Acute Respiratory Infection (ARI), caregiver's knowledge of the disease was not. Therefore, when designing public health interventions to address child mortality, information-giving alone is likely to be insufficient.
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Affiliation(s)
- Ayobami A. Bakare
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Carina King
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Julius Salako
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Damola Bakare
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Obioma C. Uchendu
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Funmilayo Shittu
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Agnese Iuliano
- Institute for Global Health, University College London, London, United Kingdom
| | - Adamu Isah
- Save the Children International, Abuja, Nigeria
| | | | - Samy Ahmar
- Save the Children UK, London, United Kingdom
| | | | | | - Eric D. McCollum
- Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Tim Colbourn
- Institute for Global Health, University College London, London, United Kingdom
| | - Adegoke G. Falade
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | - Hamish R. Graham
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
- Centre for International Child Health, Murdoch Children’s Research Institute, University of Melbourne, Royal Children’s Hospital, Parkville, VIC, Australia
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Salako J, Bakare D, Colbourn T, Isah A, Adams O, Shittu F, Uchendu O, Bakare AA, Graham H, McCollum ED, Falade AG, Burgess RA, King C. Maternal mental well-being and recent child illnesses-A cross-sectional survey analysis from Jigawa State, Nigeria. PLOS Glob Public Health 2023; 3:e0001462. [PMID: 36962998 PMCID: PMC10121178 DOI: 10.1371/journal.pgph.0001462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/11/2022] [Indexed: 03/06/2023]
Abstract
Child health indicators in Northern Nigeria remain low. The bidirectional association between child health and maternal well-being is also poorly understood. We aim to describe the association between recent child illness, socio-demographic factors and maternal mental well-being in Jigawa State, Nigeria. We analysed a cross-sectional household survey conducted in Kiyawa local government area, Jigawa State, from January 2020 to March 2020 amongst women aged 16-49 with at least one child under-5 years. We used two-stage random sampling. First, we used systematic random sampling of compounds, with the number of compounds based on the size of the community. The second stage used simple random sampling to select one eligible woman per compound. Mental well-being was assessed using the Short Warwick-Edinburgh Mental Wellbeing Score (SWEMWBS). We used linear regression to estimate associations between recent child illness, care-seeking and socio-demographic factors, and mental well-being. Overall 1,661 eligible women were surveyed, and 8.5% had high mental well-being (metric score of 25.0-35.0) and 29.5% had low mental well-being (metric score of 7.0-17.9). Increasing wealth quintile (adj coeff: 1.53; 95% CI: 0.91-2.15) not being a subsistence farmer (highest adj coeff: 3.23; 95% CI: 2.31-4.15) and having a sick child in the last 2-weeks (adj coeff: 1.25; 95% CI: 0.73-1.77) were significantly associated with higher mental well-being. Higher levels of education and increasing woman's age were significantly associated with lower mental well-being. Findings contradicted our working hypothesis that a recently sick child would be associated with lower mental well-being. We were surprised that education and late marriage, which are commonly attributed to women's empowerment and autonomy, were not linked to better well-being here. Future work could focus on locally defined tools to measure well-being reflecting the norms and values of communities, ensuring solutions that are culturally acceptable and desirable to women with low mental well-being are initiated.
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Affiliation(s)
- Julius Salako
- Department of Health Promotion and Education, University College Hospital, Ibadan, Nigeria
| | - Damola Bakare
- Department of Epidemiology and Medical Statistics, University College Hospital, Ibadan, Nigeria
| | - Tim Colbourn
- Institute for Global Health, University College London, London, United Kingdom
| | - Adamu Isah
- Save the Children International, Abuja, Nigeria
| | - Osebi Adams
- Save the Children International, Abuja, Nigeria
| | - Funmilayo Shittu
- Department of Health Promotion and Education, University College Hospital, Ibadan, Nigeria
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Obioma Uchendu
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayobami A Bakare
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Hamish Graham
- Centre for International Child Health, Murdoch Children's Research Institute, University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Eric D McCollum
- Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD, United States of America
| | - Adegoke G Falade
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | | | - Rochelle A Burgess
- Institute for Global Health, University College London, London, United Kingdom
| | - Carina King
- Institute for Global Health, University College London, London, United Kingdom
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Andersen KN, Shittu F, Magama A, Ahmed T, Bakare D, Salako J, Burgess RA, King C. Perceptions of child death in Jigawa State, Nigeria: a mixed-methods study on how sociocultural nuances shape paediatric mortality reporting. Glob Health Action 2022; 15:2120251. [DOI: 10.1080/16549716.2022.2120251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Funmilayo Shittu
- Department of Pediatrics, University of Ibadan, Ibadan, Nigeria and University College Hospital, Ibadan, Nigeria
| | | | | | - Damola Bakare
- Department of Pediatrics, University of Ibadan, Ibadan, Nigeria and University College Hospital, Ibadan, Nigeria
| | - Julius Salako
- Department of Pediatrics, University of Ibadan, Ibadan, Nigeria and University College Hospital, Ibadan, Nigeria
| | | | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Institute for Global Health, University College London, London, UK
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King C, Siddle M, Adams O, Ahmar S, Ahmed T, Bakare AA, Bakare D, Burgess RA, Colbourn T, McCollum ED, Olowookere T, Salako J, Uchendu O, Graham HR, Falade AG. Prevalence of pneumonia and malnutrition among children in Jigawa state, Nigeria: a community-based clinical screening study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001640. [PMID: 36645778 PMCID: PMC9577914 DOI: 10.1136/bmjpo-2022-001640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To estimate the point prevalence of pneumonia and malnutrition and explore associations with household socioeconomic factors. DESIGN Community-based cross-sectional study conducted in January-June 2021 among a random sample of households across all villages in the study area. SETTING Kiyawa Local Government Area, Jigawa state, Nigeria. PARTICIPANTS Children aged 0-59 months who were permanent residents in Kiyawa and present at home at the time of the survey. MAIN OUTCOME MEASURES Pneumonia (non-severe and severe) defined using WHO criteria (2014 revision) in children aged 0-59 months. Malnutrition (moderate and severe) defined using mid-upper arm circumference in children aged 6-59 months. RESULTS 9171 children were assessed, with a mean age of 24.8 months (SD=15.8); 48.7% were girls. Overall pneumonia (severe or non-severe) point prevalence was 1.3% (n=121/9171); 0.6% (n=55/9171) had severe pneumonia. Using an alternate definition that did not rely on caregiver-reported cough/difficult breathing revealed higher pneumonia prevalence (n=258, 2.8%, 0.6% severe, 2.2% non-severe). Access to any toilet facility was associated with lower odds of pneumonia (aOR: 0.56; 95% CI: 0.31 to 1.01). The prevalence of malnutrition (moderate or severe) was 15.6% (n=1239/7954) with 4.1% (n=329/7954) were severely malnourished. Being older (aOR: 0.22; 95% CI: 0.17 to 0.27), male (aOR: 0.77; 95% CI: 0.66 to 0.91) and having head of compound a business owner or professional (vs subsistence farmer, aOR 0.71; 95% CI: 0.56 to 0.90) were associated with lower odds of malnutrition. CONCLUSIONS In this large, representative community-based survey, there was a considerable pneumonia and malnutrition morbidity burden. We noted challenges in the diagnosis of Integrated Management of Childhood Illness-defined pneumonia in this context.
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Affiliation(s)
- Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Morgan Siddle
- Institute for Global Health, University College London, London, UK
| | - Osebi Adams
- Save the Children International, Abuja, Nigeria
| | | | | | - Ayobami Adebayo Bakare
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Department of Community Medicine, University College Hospital Ibadan, Ibadan, Nigeria
| | - Damola Bakare
- Paediatrics, University College Hospital Ibadan, Ibadan, Nigeria
| | | | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | - Eric D McCollum
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | - Julius Salako
- Paediatrics, University College Hospital Ibadan, Ibadan, Nigeria
| | - Obioma Uchendu
- Department of Community Medicine, University College Hospital Ibadan, Ibadan, Nigeria.,Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | - Hamish R Graham
- Paediatrics, University College Hospital Ibadan, Ibadan, Nigeria .,International Child Health, MCRI, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adegoke Gbadegesin Falade
- Paediatrics, University College Hospital Ibadan, Ibadan, Nigeria.,College of Medicine, University of Ibadan, Ibadan, Nigeria
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King C, Burgess RA, Bakare AA, Shittu F, Salako J, Bakare D, Uchendu OC, Iuliano A, Isah A, Adams O, Haruna I, Magama A, Ahmed T, Ahmar S, Cassar C, Valentine P, Olowookere TF, MacCalla M, Graham HR, McCollum ED, Falade AG, Colbourn T. 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. Trials 2022; 23:95. [PMID: 35101109 PMCID: PMC8802253 DOI: 10.1186/s13063-021-05859-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Child 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, is low. Additionally, knowledge, care-seeking and health system factors are poor. Therefore, a whole systems approach is needed for sustainable reductions in child mortality. METHODS This is a cluster randomised controlled trial, with integrated process and economic evaluations, conducted from January 2021 to 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 and 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) 4480 compounds with 3 eligible children per compound, (c) 80% power, (d) 5% significance, (e) intra-cluster correlation of 0.007 and (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. DISCUSSION This 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 REGISTRATION ISRCTN 39213655 . Registered on 11 December 2019.
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Affiliation(s)
- Carina King
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18, 171 65, Stockholm, Sweden.
- Institute for Global Health, University College London, London, UK.
| | | | - Ayobami A Bakare
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18, 171 65, Stockholm, Sweden
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Funmilayo Shittu
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Julius Salako
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Damola Bakare
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Obioma C Uchendu
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | - Agnese Iuliano
- Institute for Global Health, University College London, London, UK
| | - Adamu Isah
- Save the Children International, Abuja, Nigeria
| | - Osebi Adams
- Save the Children International, Abuja, Nigeria
| | | | | | | | | | | | | | | | | | - Hamish R Graham
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
- Centre for International Child Health, Murdoch Children's Research Institute, University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Eric D McCollum
- Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, USA
| | - Adegoke G Falade
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
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