<p><strong>BACKGROUND: </strong>Perceptions and practices of parties in pediatric pain are critical in children's access to adequate acute pain management. The personal factors of the child and parents have been shown to be central to pediatric pain management by the Symptom Management Theory.</p>

<p><strong>AIM: </strong>To describe children and parents/guardians' perceptions (knowledge, attitudes and beliefs) and practices regarding pediatric acute pain management and explain the influence of socio-cultural and environmental factors on those perceptions and practices.</p>

<p><strong>METHODS: </strong>Descriptive cross-sectional survey using modified versions of the American Pain Society Patient Outcome Questionnaire-Revised among parents/guardians and children.</p>

<p><strong>RESULTS: </strong>A convenience sample of 275 parents/guardians and 42 children aged 8 to 13 years admitted between date November 2018 and February 2019 to two Botswana tertiary hospitals completed the surveys. Forty-seven percent (n = 129) of parents/guardians reported the child to be in moderate-severe pain, while 38% (n = 16) of children reported pain as moderate-severe at the time of the survey. The children mean scores for cm-APS-POQ-R were 113(33) while parents/guardian's guardians for m-APS-POQ-R were 123(26). The subscales except for the parents/'guardians' pain interference (p = .96) were statistically significant (p = .000), showing adequate knowledge, positive attitudes and high pain intensity for both parents/guardians and children.</p>

<p><strong>CONCLUSION: </strong>Parent/guardians and children reported a high incidence of acute pain, were content with pain management services, and showed adequate knowledge of pediatric pain and its management. The incongruence between the intensity of pain, satisfaction on the adequacy of pain management and knowledge and attitudes demonstrated in this study need further inquiry.</p>

<p><strong>BACKGROUND: </strong>There is very limited clinical and observational data on acute pain experienced by children in sub-Saharan Africa.</p>

<p><strong>AIMS: </strong>To report the prevalence and intensity of acute pain, pain management practices, and describe associations between acute pain outcomes, children's and parents or guardian's demographics in hospitalized children aged 2 months to 13 years in Botswana.</p>

<p><strong>DESIGN: </strong>A descriptive correlational prospective observational study using five repeated cross-sectional samples.</p>

<p><strong>SETTINGS: </strong>Two referral hospitals in Botswana.</p>

<p><strong>PARTICIPANTS: </strong>The sample size included 308 children and 226 parents or guardians. Data were collected between November 2018 and February 2019 from children, their parents or guardians (&lt;7 years child), and the health record for pain documentation and treatment.</p>

<p><strong>MEASURES: </strong>Pain was measured using Faces Pain Scale-Revised for children ≥7 years, revised Face, Legs, Activity, Cry, Consolability scale for children &lt;7 years and numeric rating scale for parents or guardians.</p>

<p><strong>RESULTS: </strong>There are 1,290 data points for children of which 1,000 were children &lt;7 years and 999 data points for parents or guardians of children &lt;7 years were used in analysis. Fifty percent of children &lt;7 years were in pain using the revised Face, Legs, Activity, Cry, Consolability scale, whereas parents indicated 46% to be in pain. The pain prevalence for children ≥7 years was estimated at 54%. Pain was documentated at a rate of 54 % on the health records. Acetaminophen was most common analgesic across all age groups. Univariate associations of child &lt;7 years pain intensity was statistically significant (p ≤ .05) for weight, diagnosis, residence, and parent relationship. Parents reported pain intensity was statistically significant (p ≤ .05) for child sex, weight, diagnosis, residence, surgery, parent or guardian age and education. Only age and surgery were significant for children ≥7 years.</p>

<p><strong>CONCLUSIONS: </strong>Acute pain prevalence and intensity among hospitalized children in Botswana is low.</p>