Mumo, Magdaline Maureen NdukuBett, SarahJacob Masika2026-01-122026-01-122025-03https://www.iosrjournals.org/iosr-jnhs/papers/vol14-issue2/Ser-1/B1402010916.pdfhttps://ir-library.ku.ac.ke/handle/123456789/32035ArticleBackground: In Kenya, the basic level for implementing the Integrated Management of Newborn and Childhood Illness (IMNCI) guidelines is the level 3 health facilities. However, grim statistics denote possible gaps in implementation of IMNCI guidelines on pneumonia among healthcare providers working in the country’s primary health care facilities. This is also affirmed by various surveys on the INMCI implementation in Kenya which noted that implementation of IMNCI strategy remained highly inadequate in the country. To address this implementation gap, the ministry of health in Kenya has been embarking on an increased rollout of revised IMNCI guidelines. Despite the roll-out of the revised IMNCI guidelines across health care facilities, the determinants for the adherence to the pneumonia IMNCI guidelines in the county’s level 3 health facilities are unclear. This necessitates the current study that sought to determine the healthcare worker related factors influencing adherence to IMNCI guidelines for childhood pneumonia in Level 3 health facilities in Nairobi City County. Materials and Methods: This study utilized an analytical cross-sectional research design. the location for the study was Level 3 health facilities in Nairobi City County constituted the study site. The target population for the study was 443 healthcare workers (295 nurses and 148 clinical officers) attending to infants/young children. The sample size for the study was 65 respondents, comprising of 44 nurses and 21 clinical officers. The research instrument used in this study was a self-administered/self-reported questionnaire. Data from the questionnaires was quantitative in nature and were analyzed using descriptive statistics. This included frequencies and percentages. Further, assessment of how the study’s explanatory and explained variables related was undertaken with chi-square test at 95% confidence-interval with p values ≤ 0.05 denoting existence of a statistically significant association between the study variables. The study’s outcomes were presented as figures and tables. The analytical software utilized was SPSS v.25. Results: The healthcare worker related factors found to have a statistically significant association with adherence to the IMNCI guidelines on management of pneumonia were education level of the healthcare workers (χ2 = 15.27, p = 0.002); years spent in caring for under-fives (χ2 = 8.81, p = 0.032); interaction with sick children (χ2 = 11.07, p = 0.032); training on the IMNCI guidelines (χ2 = 9.20, p = 0.02); being aware of and knowledgeable of the IMNCI guidelines (χ2 = 14.45, p < 0.0001); and attitude towards the IMNCI guidelines on pneumonia (χ2 = 16.63, p < 0.0001). Conclusion: Majority of the healthcare workers working in level 3 health facilities in Nairobi City County adhered to the IMNCI guidelines on management of childhood pneumonia. From the results education level of the healthcare workers, years spent in caring for under-fives, interaction with sick children, training on the IMNCI guidelines, being aware of and knowledgeable of the IMNCI guidelines and attitude towards the IMNCI guidelines on pneumonia were the healthcare worker related factors that influenced adherence to the IMNCI guidelines on pneumonia among healthcare workers in level 3 health facilities in Nairobi City CountyenArticle