Save A Child's breath: A Pneumonia Programme For Under-5 Children In Northern Nigeria (Jigawa state)

Pneumonia remains the leading infectious cause of death among children under five globally, with Nigeria bearing a disproportionate burden, accounting for over 100,000 annual deaths and nearly 15% of global childhood pneumonia mortality. Despite having Africa's largest economy, Nigeria struggles with weak healthcare infrastructure, limited vaccination coverage, and significant regional disparities, particularly in northern states like Jigawa where poverty, indoor air pollution, and inadequate healthcare access converge. This paper presents the Save A Child's Breath Programme (SAC-BP), a three-year pilot intervention designed to reduce under-five pneumonia mortality in Jigawa state through community case management. The programme aims to increase caregiver care-seeking behaviors by 53%, scale up amoxicillin dispersible tablets and pulse oximetry supply by 30%, and improve pneumonia diagnosis and treatment rates by 70% through training community health workers. Critical appraisal of intervention options demonstrates that community case management offers a more cost-effective and feasible approach than vaccination alone, particularly in resource-limited settings with low immunization coverage. Implementation will leverage existing national policies and partnerships while addressing key risks including antibiotic resistance, supply chain challenges, and political transitions. This equity-focused intervention has potential to prevent over one million additional childhood deaths while contributing to Sustainable Development Goal 3.2 of ending preventable child deaths by 2030.