Background: Prompt administration of antibiotics to children with pneumonia significantly reduces the probability of death. However this requires early identification of such children in the community. In a country such as Nigeria with one of the highest pneumoniarelated deaths, what do mothers know about pneumonia, and what should be the content of public campaign messages? Methods: A structured questionnaire was administered to mothers attending paediatric clinics of Lagos University Teaching Hospital seeking their knowledge about the definition, causes, risk factors and symptoms of childhood pneumonia. Results: One hundred and seven (107) consecutive mothers participated in the study. The majority (97; 90.6%) had at least secondary education, were married (96; 89.7%) and professed to be either Christians or Muslims (105; 98.1%).Prior to the study, 16 (15%) had not heard about pneumonia. About half of the participants correctly identified fast/difficult breathing as suggestive of pneumonia. Threequarters reported exposure to cold as the cause of childhood pneumonia. Minimizing exposure to cold and wearing warm clothes were the two commonest reported ways of preventing pneumonia (75.8% and 49.5% of the mothers respectively); in contrast hand washing, exclusive breastfeeding and limiting exposure to sick persons with cough and catarrh were the least mentioned. The proportion of mothers who correctly identified fast/difficult breathing as suggestive of pneumonia was similar irrespective of educational status or source of pneumonia information. Conclusion: Mothers' knowledge of childhood pneumonia is low. Public campaigns on pneumonia should focus on raising awareness about germs as cause of pneumonia, immunization, hand washing and exclusive breastfeeding as potent preventive strategies and fast/difficult breathing as a feature of pneumonia.

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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 coverageacross 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 frommembers 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 betweennumber of paediatricians and U5MR and diphtheria-pertussistetanus(DPT) vaccine coverage.Results: There were 492 practicing paediatricians in Nigeria at theend of year 2011, comprising 282 (57.3%) males and 210 (42.7%)females; 476 (96.7%). Majority (84.7%) worked for the governmentwith 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 wa s 157,878:1for the country. TheNorth East zone had the highest chi ld- to-pa ediat r ician rat io (718,412:1) while South West had the lowest ratio (95,682:1).Higher absolute numbers of paediatricians in each zone were associatedwi th lower U5MR (Spearman ñ=-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 ñ=0.82, p=0.04,linear R2=0.73) and marginally with lower DPT coverage by geopoliticalzone (Spearman ñ=-0.77, p=0.07, linear R2=0.59).Conclusion: The study reveals that the number of paediatricians inNigeria 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 workforceKey words: Paediatrician, workforce, child-to-paediatrician ratio, under-5 mortality, immunization, childhealth, Nigeria

Background: Vaccine preventable diseases account for 22% of under-five deaths in Nigeria and poor knowledge and attitude have been responsible for non-vaccination of children. This study aimed to assess the knowledge,attitude and practice of childhood immunization among community members in Ile-Ife.Methods: Quantitative data (using an interviewer-administered questionnaire) was collected from a convenience sample of 36 adultresidents who attended a town hall meeting with the PaediatricAssociation of Nigeria. Two focus group discussions were also conductedamong sub-samples of male and female respondents.Results: The mean age of respondents was 43.2 ± 11.9 years with amale to female ratio of 1:0.7. Most had secondary education (63.9%)and had children (91.7%). Most of the respondents understood whatimmunization was and knew the benefits but were unaware of severalof the specific types of immunization. There were erroneous beliefs about the contraindications for immunization and mothers were entrusted with the sole responsibility of getting children immunized. Although most of therespondents had immunized their children, they identified laziness ofmothers, negative attitude of health workers and logistics problemsat facilities as barriers to patronage of immunization services.Conclusion: This study identified knowledge gaps and negative attitudestowards childhood immunization. We therefore recommend a community-wide health education intervention with emphasis on substantial male involvement in immunizations and improvement inimmunization service delivery.Key words: Community, knowledge, attitude, childhood immunization.