Assessment of Paediatric Emergency Care Capacity in District Hospitals in Imo State, South East Nigeria

Paediatric emergency care capacity at district hospitals is a critical but frequently neglected dimension of child health system performance in Nigeria, where the majority of childhood deaths from preventable causes occur outside tertiary facilities. This study assesses paediatric emergency care capacity at district hospitals in Imo State, examining infrastructure, equipment, human resources, case management protocols, and triage practices. A cross-sectional facility assessment is conducted at 20 general and district hospitals across three geopolitical zones of Imo State, using the Paediatric Emergency Care Assessment Tool adapted from the WHO Emergency Triage, Assessment, and Treatment guidelines. Mixed data sources include direct facility observation, document reviews of emergency protocols and training records, and key informant interviews with medical officers in charge and paediatric nursing leads. A composite Paediatric Emergency Readiness Score is calculated and compared across facility types and zones. SPSS is used for analysis with one-way ANOVA examining inter-zonal score differences. Available evidence from the Nigerian Paediatric Association 2022 assessment indicates that fewer than 30 percent of secondary-level facilities nationwide have functioning paediatric resuscitation equipment. The Integrated Management of Childhood Illness framework provides the clinical normative standard. Findings will guide Imo State's Hospital Management Board on prioritised capital investment and in-service training. Keywords: paediatric emergency care, district hospitals, emergency readiness, child health, Imo State.