This study investigated the effectiveness of simple-to-implement adjustments of phototherapy devices on irradiance levels in a cross-section of Nigerian hospitals. A total of 76 phototherapy devices were evaluated in 16 hospitals while adjustments were implemented for a subset of 25 devices for which consent was obtained. The mean irradiance level was 7.6 AE 5.9 mW/cm 2 /nm for all devices prior to adjustments. The average irradiance level improved from 9.0 mW/cm 2 /nm to 27.3 mW/cm 2 /nm for

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... e adjusted group (n ¼ 25) compared with 6.8 AE 5.4 mW/cm 2 /nm for the unadjusted group (n ¼ 51). Simple, inexpensive adjustments to phototherapy devices with sub-optimal irradiance levels can significantly improve their effectiveness to acceptable international standards and should be widely promoted in resource-constrained settings.