Assessment of the Adoption of the World Health Organization Recommendations for Hospital Nursing Care of Children with Pneumonia in Senegal

Pneumonia, the leading cause of mortality in children under age 5 years worldwide, is responsible for a significant number of pediatric deaths in Senegal, West Africa. The World Health Organization (WHO) recommendations for pneumonia case management have been shown to be effective in reducing pediatric pneumonia mortality. However global implementation of the guidelines has not been achieved, including a lack of global adoption of the recommendations for the hospital care of children with severe pneumonia. The WHO Pocket Book of Hospital Care for Children: Guidelines for the management of common illnesses with limited resources, contains the internationally accepted guidelines which includes recommendations for the inpatient care of children with severe or very severe pneumonia. Limited information is found in a review of the literature related to the implementation of these guidelines by inpatient health facilities in developing countries. A lack of educational preparation of the staff, a lack of equipment and supplies, and staffing shortages have been identified in some sub-Saharan African hospitals, but it is not known if any of these, or other issues, affect the adoption of the WHO guidelines for inpatient nursing care of children with pneumonia at a first level health facility in Senegal.
This descriptive study used information obtained through a survey of nurses to assess the reported nursing care for children with severe pneumonia in a first level health facility, Hospital Youssou M’bargane Diop, in Rufisque, Senegal and compared the findings with the WHO guidelines for care of hospitalized children with pneumonia. The findings indicate the reported care that is consistent with the WHO recommendations, indicating implementation and adoption of the WHO guidelines. This study found a high degree of nursing procedural confidence and how-to knowledge, indicating the nursing role in this setting is a strong and important component in the adoption of the WHO guidelines for care for hospitalized children with pneumonia. Two potential barriers were found which could limit the delivery of guideline consistent care; the potential shortage of necessary materials and possible inadequate nursing time.
International nursing research should be encouraged to identify and support nursing expertise that promotes global adoption of the WHO guidelines.