<![CDATA[Background: Pneumonia remains a leading cause of morbidity and mortality among children under five years of age, particularly in developing Asian countries. Limited healthcare access and suboptimal service quality contribute to delayed diagnosis and inadequate management. However, evidence on health system factors influencing childhood pneumonia management remains fragmented and has not been comprehensively mapped regionally. Objective: This scoping review aimed to identify, map, and synthesize evidence on healthcare service factors influencing pneumonia management among under-five children in developing Asian countries. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and reported according to the PRISMA Extension for Scoping Reviews. Literature published between 2015 and 2025 was searched in PubMed, Scopus, and EBSCO. Eligible studies were selected using the Population–Concept–Context framework and synthesized through descriptive thematic analysis. Results: Of 1,908 records identified, 11 studies met the inclusion criteria. The studies represented six developing Asian countries: Bangladesh, Pakistan, India, Indonesia, Vietnam, and Nepal. Four interrelated themes emerged: healthcare accessibility and service quality as core health-system factors, and caregiver awareness and health-seeking behavior, as well as socioeconomic and cultural conditions, as contextual factors influencing healthcare utilization and the timeliness of pneumonia management. Conclusion: Healthcare service factors play an important role in childhood pneumonia management. Strengthening primary healthcare services, healthcare worker capacity, caregiver health literacy, and access to care may support more timely pneumonia management and improve health outcomes among children under five years of age.]]>
