{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:14:03Z","timestamp":1788444843585,"version":"build-2803163510"},"reference-count":28,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,5,25]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Acute kidney injury is a global health concern with significant implications for morbidity and mortality when it comes to children. High morbidity and mortality result from consequences such as metabolic acidosis, hyperkalaemia, fluid overload and cardiovascular issues. Good clinical outcomes among children with acute kidney injury can be achieved through early recognition and initiation of management to prevent disease progression. However, evidence on early recognition and management of acute kidney injury in children is lacking, especially in low-resource settings such as Tanzania. This study explores healthcare providers\u2019 experiences with early recognition and management of acute kidney injury among children attending primary healthcare facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This exploratory qualitative case study aims to capture contextual experiences using semi-structured interviews to gain thematic insights. The estimated sample size for this study is 20 informants and will be selected purposively. Data will be collected through individual interviews using an interview guide with predetermined questions followed by probing questions. Each interview session will last for about 30\u201360\u2009min. Data analysis will begin during the data collection period using the six-phase thematic analysis approach by Braun and Clarke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval has been provided by the Muhimbili University of Health and Allied Sciences Senate of Research and Ethical Committees with reference number DA.282\/298\/01.C\/2630. In accordance with the Declaration of Helsinki (1964) and its later amendments, all respondents will provide verbal and written informed consent and will be free to participate voluntarily with no incentives. The findings will be shared with participating healthcare facilities, district and regional health authorities and relevant stakeholders through presentations and summary reports. Findings will also be presented at national and international scientific conferences and submitted for publication in peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-113598","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:05:15Z","timestamp":1780502715000},"page":"e113598","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Using Donabedian\u2019s model to explore healthcare providers\u2019 perspectives on early recognition and initial management of paediatric acute kidney injury in rural Tanzania: a qualitative case study protocol"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7459-7864","authenticated-orcid":false,"given":"Dedius E","family":"Peter","sequence":"first","affiliation":[{"name":"Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dickson A","family":"Mkoka","sequence":"additional","affiliation":[{"name":"Department of Clinical Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pius","family":"Temba","sequence":"additional","affiliation":[{"name":"Department of Clinical Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter C","family":"Millanzi","sequence":"additional","affiliation":[{"name":"Department of Nursing Management and Education, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"2026090306255848000_16.6.e113598.1","first-page":"2","article-title":"Etiology, Clinical Profile, and Short-Term Outcome of Children With Acute Kidney Injury","volume":"14","author":"Bai","year":"2022","journal-title":"Cureus"},{"key":"2026090306255848000_16.6.e113598.2","doi-asserted-by":"publisher","DOI":"10.1016\/J.KINT.2023.10.018"},{"key":"2026090306255848000_16.6.e113598.3","doi-asserted-by":"crossref","unstructured":"Lansdown G , Vaghri Z . Article 1: definition of a child.2022:407\u201312.","DOI":"10.1007\/978-3-030-84647-3_40"},{"key":"2026090306255848000_16.6.e113598.4","doi-asserted-by":"crossref","first-page":"2807","DOI":"10.1007\/s00467-024-06399-1","article-title":"Dialysis for paediatric acute kidney injury in Cape Town, South Africa","volume":"39","author":"McCulloch","year":"2024","journal-title":"Pediatr Nephrol"},{"key":"2026090306255848000_16.6.e113598.5","doi-asserted-by":"crossref","first-page":"15672","DOI":"10.1038\/s41598-021-94946-3","article-title":"Mortality and predictors of acute kidney injury in adults: a hospital-based prospective observational study","volume":"11","author":"Abebe","year":"2021","journal-title":"Sci Rep"},{"key":"2026090306255848000_16.6.e113598.6","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s00467-023-06164-w","article-title":"Epidemiology of acute kidney injury in children: a report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference","volume":"39","author":"Sutherland","year":"2024","journal-title":"Pediatr Nephrol"},{"key":"2026090306255848000_16.6.e113598.7","doi-asserted-by":"crossref","first-page":"40","DOI":"10.23876\/j.krcp.20.074","article-title":"Pediatric acute kidney injury: new advances in the last decade","volume":"40","author":"Sethi","year":"2021","journal-title":"Kidney Res Clin Pract"},{"key":"2026090306255848000_16.6.e113598.8","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41390-021-01452-3","article-title":"Advances in pediatric acute kidney injury","volume":"91","author":"Raina","year":"2022","journal-title":"Pediatr Res"},{"key":"2026090306255848000_16.6.e113598.9","doi-asserted-by":"crossref","unstructured":"Kapologwe NA , Kengia JT , Killewo J , et al . Primary health care in Tanzania through a health systems lens: a history of the struggle for universal health coverage. 2023.","DOI":"10.1079\/9781800623330.0000"},{"key":"2026090306255848000_16.6.e113598.10","unstructured":"PORALG . Primary health care (Phc) rolling digital transformation roadmap. 2023.1\u201350. 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Burns & Grove\u2019s the Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence. 9th edn. 2021."},{"key":"2026090306255848000_16.6.e113598.27","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1108\/QRJ-08-2022-0116","article-title":"Application of Guba and Lincoln\u2019s parallel criteria to assess trustworthiness of qualitative research on indigenous social protection systems","volume":"23","author":"Enworo","year":"2023","journal-title":"QRJ"},{"key":"2026090306255848000_16.6.e113598.28","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30925-9"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-113598","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:26:56Z","timestamp":1788442016000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-113598"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,3]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/bmjopen-2025-113598"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-113598","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}