Healthy Start Initiative, Ikoyi, Lagos, Nigeria.
BMC Int Health Hum Rights. 2012 Jul 2;12:9. doi: 10.1186/1472-698X-12-9.
An understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries. This study therefore elicited the views of paediatricians on current global priorities for newborn health in Nigeria as possible guide for policy makers.
Paediatric consultants and residents in the country were surveyed nationally between February and March 2011 using a questionnaire requiring the ranking of nine prominent and other neonatal conditions based separately on hospital admissions, mortality, morbidity and disability as well as based on all health indices in order of importance or disease burden. Responses were analysed with Friedman test and differences between subgroups of respondents with Mann-Whitney U test.
Valid responses were received from 152 (65.8%) of 231 eligible physicians. Preterm birth/low birthweight ranked highest by all measures except for birth asphyxia which ranked highest for disability. Neonatal jaundice ranked next to sepsis by all measures except for disability and above tetanus except mortality. Preterm birth/low birthweight, birth asphyxia, sepsis, jaundice and meningitis ranked highest by composite measures while jaundice had comparable rating with sepsis. Birth trauma was most frequently cited under other unspecified conditions. There were no significant differences in ranking between consultants and residents except for birth asphyxia in relation to hospital admissions and morbidity as well as sepsis and tetanus in relation to mortality.
Current global priorities for neonatal survival in Nigeria largely accord with paediatricians' views except for neonatal jaundice which is commonly subsumed under "other" or "miscellaneous" neonatal conditions. While the importance of these priority conditions extends beyond mortality thus suggesting the need for a broader conceptualisation of newborn health to reflect the current realities, paediatricians should be actively engaged in advancing the attainment of global priorities for child survival and health in this population.
了解儿科医生作为儿童保健服务关键利益相关者的看法，以及与当前投资重点的一致性程度，对于加快实现发展中国家儿童生存和整体健康全球目标至关重要。因此，本研究旨在了解尼日利亚儿科医生对当前全球新生儿健康优先事项的看法，以期为决策者提供参考。
2011 年 2 月至 3 月，通过问卷调查对该国的儿科顾问和住院医师进行了全国范围的调查，要求他们根据住院、死亡率、发病率和残疾，以及所有健康指标的重要性或疾病负担，分别对 9 种突出的和其他新生儿疾病进行排名。采用 Friedman 检验对数据进行分析，并采用 Mann-Whitney U 检验对不同受访者亚组之间的差异进行分析。
共收到 231 名符合条件的医生中的 152 名（65.8%）有效回复。除了与残疾相关的排名最高的窒息性分娩/低出生体重外，所有指标均将早产儿/低出生体重列为首位。除了与残疾相关的排名最高的破伤风外，所有指标均将新生儿黄疸排在败血症之后。除了死亡率外，早产儿/低出生体重、窒息性分娩、败血症、黄疸和脑膜炎在综合指标中排名最高，而黄疸与败血症的评分相当。出生创伤在其他未指明的情况下最常被提及。顾问和住院医师之间的排名差异无统计学意义，除了与住院和发病率相关的窒息性分娩以及与死亡率相关的败血症和破伤风。
尼日利亚当前的新生儿生存全球优先事项在很大程度上与儿科医生的观点一致，但新生儿黄疸通常被归入“其他”或“杂项”新生儿疾病。虽然这些优先疾病的重要性超出了死亡率，因此需要更广泛地概念化新生儿健康，以反映当前的现实，但应积极让儿科医生参与到实现该人群儿童生存和健康的全球优先事项中来。
