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INSPIRING

The Integrated Sustainable Childhood Pneumonia and Infectious disease Reduction in Nigeria (INSPIRING) programme evaluation and research

Project Summary 

Pneumonia is the second leading cause of infectious deaths, with 880,000 deaths in 2016, and half of these occurred in just 5 countries, one of which is Nigeria. This project will be conducted in Jigawa (north-west), and Lagos (south-west) states in Nigeria. All interventions will be delivered by Save the Children Nigeria independently of the evaluation by UCL. The project will be divided into three phases, and include a impact, process and economic evaluations for the intervention packages in each state.

Jigawa

The under-5 mortality in Jigawa state is 192/1000 livebirths, and we estimate that there are 14,988 cases of paediatric pneumonia in Jigawa annually. 

This project is a cluster randomised trial of a complex intervention to build capacity of communities and health care providers in Kiyawa LGA on paediatric pneumonia. This will be done through three intervention components: men’s and women’s community groups; healthcare worker training in integrated management of childhood illnesses (IMCI) and a community-facility link group for accountability. 

The aim of the trial evaluation is to determine the impact of the complex intervention package on all- cause deaths in children aged 0-59 months. The trial will include all communities in Kiyawa LGA, a population of 230,000, with approximately 57,000 children under-five years of age. 

Lagos

The under-5 mortality in Lagos state is 50/1000 livebirths, and we estimate that there are 17,955 cases of paediatric pneumonia in Lagos annually. 

This project is a time-series analysis, of a complex intervention package including oximetry, oxygen support and training package for both primary and secondary care. The INSPIRING Project will provide the pulse oximeter devices and facilitate training in IMCI (or iCCM where appropriate) guidelines. Oxygen systems will upgraded to ensure they are of minimum medical standard, have uninterrupted power supplies, and trained staff to deliver oxygen treatment to children. 

The overall aim of this project is to evaluate the impact and cost-effectiveness of an integrated training and mentorship approach to the introduction of pulse oximetry and enhanced sustainable oxygen systems in Ikorodu local government area (LGA) in Lagos state, Nigeria, on the case fatality rate of paediatric pneumonia in children aged 0-59 months.

Publications

Measuring oxygen access: lessons from health faciliity assessments in Lagos, Nigeria

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

Pulse oximetry and oxygen services for the care of children with pneumonia attending frontline health facilities in Lagos, Nigeria (INSPIRING-Lagos): study protocol for a mixed-methods evaluation​​​​​​​

Prevalence of pneumonia and malnutrition among children in Jigawa state, Nigeria: a community-based clinical screening study​​​​​​​

Perceptions of child death in Jigawa State, Nigeria: a mixed-methods study on how sociocultural nuances shape paediatric mortality reporting

Maternal mental well-being and recent child illnesses–A cross-sectional survey analysis from Jigawa State, Nigeria

Care seeking for under-five children and vaccine perceptions during the first two waves of the COVID-19 pandemic in Lagos State, Nigeria: a qualitative exploratory study

Whose knowledge counts? Involving communities in intervention and trial design using community conversations​​​​​​​

Pneumonia knowledge and care seeking behavior for children under-five years in Jigawa, Northwest Nigeria: a cross-sectional study​​​​​​​

The first four papers from the study were published in Pediatric Pulmonology on 27th January 2020:

The burden and risks of pediatric pneumonia in Nigeria: A desk‐based review of existing literature and data

Health system challenges for improved childhood pneumonia case management in Lagos and Jigawa, Nigeria

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

A mixed‐methods evaluation of stakeholder perspectives on pediatric pneumonia in Nigeria—priorities, challenges, and champions

Links to other research

Other research from the Centre for the Health of Women, Children and Adolescents

Other research from IGH on Child Health, Prevention, Treatment, Health Care and Infectious Diseases

Other research from IGH in Nigeria