Paediatrician workforce in Nigeria and impact on child health

Type Journal Article - Nigerian Journal of Paediatrics
Title Paediatrician workforce in Nigeria and impact on child health
Volume 40
Issue 2
Publication (Day/Month/Year) 2013
Page numbers 112-118
Objective: To determine
the number and distribution of
paediatricians in Nigeria. It also
aims to determine the association
between paediatrician workforce
and under five mortality (U5MR)
and immunization coverage
across the six geopolitical zones
of the country.
Methods: The part II fellowship
examination pass list of the West
African College of Physicians and
the National Postgraduate Medical
College and the register and
financial records of the Paediatric
Association of Nigeria were
searched for the purpose of the
study. Using a structured questionnaire,
personal and professional
data was obtained from
members at the 2011 Annual Paediatric
Association of Nigeria
Conference or via the Association’s
website, email network and
phone calls to Departments of
Paediatrics in institutions (private
and public) across the Country.
Data on the paediatricians residing
within Nigeria was then extracted
from the comprehensive
database and subsequently analyzed.
Population data, mortality
and immunization rates were obtained
from the National Population
Commission census and their
most recent National Demographic
health survey in Nigeria.
Correlations were drawn between
number of paediatricians and
U5MR and diphtheria-pertussistetanus
(DPT) vaccine coverage.
Results: There were 492 practicing
paediatricians in Nigeria at the
end of year 2011, comprising 282
(57.3%) males and 210 (42.7%)
females; 476 (96.7%). Majority
(84.7%) worked for the government
with 97% of them in hospital
settings, mostly tertiary centres
(344=88%). Lagos State had the
highest number (85; 17.9%) of
practicing paediatricians followed
by the Federal Capital Territory
with 37 (7.8%) paediatricians.
More than two thirds of the paediatricians
(336; 70.6%) were
practicing in the southern part of
the country. The average child:
p a e d i a t r i c i a n r a t i o w a s
157,878:1for the country. The
North East zone had the highest
child-to-paediatrician ratio
(718,412:1) while South West had
the lowest ratio (95,682:1).
Higher absolute numbers of paediatricians
in each zone were associated
with lower U5MR
(Spearman ?=-0.94, p=0.0048),
accounting for 84% of the variability
among zones. Higher ratios of
child-to-paediatrician were significantly
associated with higher
U5MR (Spearman ?=0.82, p=0.04,
linear R2
=0.73) and marginally
with lower DPT coverage by geopolitical
zone (Spearman ?=-0.77,
p=0.07, linear R2
Conclusion: The study reveals that
the number of paediatricians in
Nigeria is grossly inadequate with
a huge child-to-paediatrician ratio.
There is also an uneven distribution
of the paediatricians with
higher numbers in the southern
states. Zones of the country with
lower child-to-paediatrician ratios
also experienced lower U5MR.
There is a need to train more paediatricians
in Nigeria and promote
an even distribution of the paediatrician

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