Table 1 Challenges of Emergency Medicine Practice in Nigeria and the way forward

Inadequate Capacity (human resources and equipment)

• Inadequate numbers of trained emergency personnel/unavailability of accredited paediatric emergency medicine training centers

Institute formal training programmes in accredited centers to educate and train different cadres of hospital staff in skills for pediatric emergency care and life support practices to improve child survival.

Poor standard of care

• Inappropriate management of children at home/community

Organise health education programmes for parents/caregivers of children particularly, mothers on appropriate home treatment and need for early presentation to the health facility.

Institute skill acquisition programmes for community health workers with emphasis on simple life saving interventions that may be useful while taking necessary steps to facilitate referral at appropriate time.

• Lack of coordinated referral and transport of sick children

Institute a well-coordinated referral, communication, and transport system between facilities to enhance early and safe arrival of the sick child to the facility for appropriate intervention.

• Inadequate numbers/distribution of health personnel in the hospitals

Employ adequate numbers of health workers to cater for the patients in the emergency units.

• Unavailability of basic equipment

Provide basic equipment needed to improve quality of care and outcome of childhood illnesses.

Poor policy prioritization/implementation

and funding of health care services

• Lack of prioritisation and implementation a country-wide policy for paediatric emergency medicine practice

Institute a well-planned policy on paediatric emergency service and hold relevant ministries/parastatals and regional health authorities accountable for proper implementation.

• Poor funding of health care and dysfunctional health insurance scheme

Increase health care budget and institute a functional health insurance scheme in Nigeria to ensure free health care services to the disadvantaged population of children.

• Enormous out of pocket expenses

Harmonize expenditure/billing system such that the life of the child is prioritised over immediate need for out of payments by caregivers.

• Skewed orientation/provision of health service in favour of adults

Ensure equity in service by fostering more child oriented health services.