Identifying challenges in implementing child rights instruments in Nigeria: A nationwide survey of knowledge, perception, and practice of child rights among doctors and nurses.

Context: After thirty years of ratifying the child rights convention and nineteen years of the Child Rights Act, implementing child rights instruments remains challenging in Nigeria. Healthcare providers are well positioned to change the current paradigm. Aim: To examine the knowledge, perception, and practice of child rights and the influence of demographics among Nigerian doctors and nurses. Materials and Methods: A descriptive, cross-sectional online survey was done using nonprobability sampling. Pretested multiple-choice questionnaire was disseminated across Nigeria's six geopolitical zones. Performance was measured on the frequency and ratio scales. Mean scores were compared with 50% and 75% thresholds. Results: A total of 821 practitioners were analyzed (doctors, 49.8%; nurses, 50.2%). Female-to-male ratio was 2:1 (doctors, 1.2:1; nurses, 3.6:1). Overall, knowledge score was 45.1%; both groups of health workers had similar scores. Most knowledgeable were holders of fellowship qualification (53.2%, P = 0.000) and pediatric practitioners (50.6%, P = 0.000). Perception score was 58.4% overall, and performances were also similar in both groups; females and southerners performed better (59.2%, P = 0.014 and 59.6%, P = 0.000, respectively). Practice score was 67.0% overall; nurses performed better (68.3% vs. 65.6%, P = 0.005) and postbasic nurses had the best score (70.9%, P = 0.000). Conclusions: Overall, our respondents' knowledge of child rights was poor. Their performances in perception and practice were good but not sufficient. Even though our findings may not apply to all health workers in Nigeria, we believe teaching child rights at various levels of medical and nursing education will be beneficial. Stakeholder engagements involving medical practitioners are crucial.

Résumé Contexte: Après trente ans de ratification de la convention sur les droits de l'enfant et dix-neuf ans de la loi sur les droits de l'enfant, la mise en œuvre des instruments relatifs aux droits de l'enfant reste difficile au Nigéria. Les fournisseurs de soins de santé sont bien placés pour changer le paradigme actuel. Objectif: Examiner la connaissance, la perception et la pratique des droits de l'enfant et l'influence de la démographie parmi les médecins et les infirmières nigérians. Matériels et méthodes: Une enquête en ligne descriptive et transversale a été réalisée à l'aide d'un échantillonnage non probabiliste. Un questionnaire à choix multiples prétesté a été diffusé dans les six zones géopolitiques du Nigeria. Les performances ont été mesurées sur les échelles de fréquence et de rapport. Les scores moyens ont été comparés aux seuils de 50 % et 75 %. Résultats: Au total, 821 praticiens ont été analysés (médecins, 49,8 % ; infirmiers, 50,2 %). Le ratio femmes/hommes était de 2 : 1 (médecins, 1,2 : 1 ; infirmières, 3,6 : 1). Dans l'ensemble, le score de connaissances était de 45,1 % ; les deux groupes avaient des scores similaires. Les plus informés étaient les titulaires d'une bourse (53,2 %, P = 0,000) et les pédiatres (50,6 %, P = 0,000). Le score de perception était de 58,4 % dans l'ensemble, et les performances étaient également similaires dans les deux groupes ; les femmes et les sudistes ont obtenu de meilleurs résultats (59,2 %, P = 0,014 et 59,6 %, P = 0,000, respectivement). Le score de pratique était de 67,0 % dans l'ensemble ; les infirmières ont obtenu de meilleurs résultats (68,3 % contre 65,6 %, P = 0,005) et les infirmières post-base ont obtenu le meilleur score (70,9 %, P = 0,000). Conclusions: Dans l'ensemble, les connaissances de nos répondants sur les droits de l'enfant étaient médiocres. Leurs performances en perception et en pratique étaient bonnes, mais pas suffisantes. Même si nos conclusions ne s'appliquent peut-être pas à tous les agents de santé au Nigeria, nous pensons que l'enseignement des droits de l'enfant à différents niveaux de la formation médicale et infirmière sera bénéfique. Les engagements des parties prenantes impliquant des médecins praticiens sont cruciaux. Mots-clés: droits de l'enfant, travailleurs de la santé, connaissances, Nigéria, perception, pratique.

Identifying challenges in implementing child rights instruments in Nigeria: A nationwide survey of knowledge, perception, and practice of child rights among doctors and nurses

Context: After thirty years of ratifying the child rights convention and nineteen years of the Child Rights Act, implementing child rights instruments remains challenging in Nigeria. Healthcare providers are well positioned to change the current paradigm. Aim: To examine the knowledge, perception, and practice of child rights and the influence of demographics among Nigerian doctors and nurses. Materials and methods: A descriptive, cross-sectional online survey was done using nonprobability sampling. Pretested multiple-choice questionnaire was disseminated across Nigeria's six geopolitical zones. Performance was measured on the frequency and ratio scales. Mean scores were compared with 50% and 75% thresholds. Results: A total of 821 practitioners were analyzed (doctors, 49.8%; nurses, 50.2%). Female-to-male ratio was 2:1 (doctors, 1.2:1; nurses, 3.6:1). Overall, knowledge score was 45.1%; both groups of health workers had similar scores. Most knowledgeable were holders of fellowship qualification (53.2%, P = 0.000) and pediatric practitioners (50.6%, P = 0.000). Perception score was 58.4% overall, and performances were also similar in both groups; females and southerners performed better (59.2%, P = 0.014 and 59.6%, P = 0.000, respectively). Practice score was 67.0% overall; nurses performed better (68.3% vs. 65.6%, P = 0.005) and postbasic nurses had the best score (70.9%, P = 0.000). Conclusions: Overall, our respondents' knowledge of child rights was poor. Their performances in perception and practice were good but not sufficient. Even though our findings may not apply to all health workers in Nigeria, we believe teaching child rights at various levels of medical and nursing education will be beneficial. Stakeholder engagements involving medical practitioners are crucial