Abstract
BackgroundCommunity Acquired Pneumonia (CAP) is the leading cause of childhood morbidity and mortality worldwide including India. Many of these deaths can be averted by creating awareness in community about early symptoms of CAP and by ensuring availability of round the clock, quality health care.The objective was to assess the effectiveness of an innovative package of orienting doctors and community health workers about community perceptions on CAP barriers to qualified health care seeking, plus infrastructural strengthening by (i) providing “Pneumonia Drug Kit” (PDK) (ii) establishing “Pneumonia Management Corner” (PMC) at additional primary health center (PHCs) and (iii) “Pneumonia Management Unit” (PMU) at Community health center (CHCs) along with one of 4 different behavior change communication interventions:Organizing Childhood Pneumonia Awareness Sessions (PAS) for caregivers of children < 5 years of age during a routine immunization day at PHCs and CHCs by Auxillary Nurse Midwives (ANM)Organizing PAS on Village Health and Nutrition Day only once a month in villages by Accredited Social Health Activist (ASHA)Combination of both Interventions 1 & 2Usual Careas measured by number of clinical pneumonia cases-treated by ANM/doctors with PDK or treated at either PMC or PMU.MethodsProspective community based open labeled behavioral trial (2 by 2 factorial design) conducted in 8 rural blocks of Lucknow district. Community survey will be done by multistage cluster sampling to collect information on changes in types of health care providers’ service utilization for ARI/CAP pre and post intervention.DiscussionCAP is one of the leading killers of childhood deaths worldwide. Studies have reported that recognition of pneumonia and its danger signs is poor among caregivers. The proposed study will assess effectiveness of various communication strategies for improving childhood pneumonia case management interventions at mother/community level, health worker and health center level. The project will generate demand and improve supply of quality of care of CAP and thus result in reduced mortality in Lucknow district. Since the work will be done in partnership with government, it can be scaled up.Trial registrationThis study has been registered retrospectively in the AEARCT Registry and the registration number is: AEARCTR-0003137.
Highlights
Community Acquired Pneumonia (CAP) is the leading cause of childhood morbidity and mortality worldwide including India
Study aim Our primary aim is to assess the effectiveness of an innovative package of orienting doctors and community health workers (CHW) about community perceptions on CAP barriers to qualified health care seeking plus infrastructural strengthening by (i) providing “Pneumonia Drug Kit” (PDK) (ii) establishing “Pneumonia Management PMU Pneumonia Management Unit (Corner)” (PMC) at additional primary health center (APHC) and (iii) “Pneumonia Management Unit” (PMU) at Community health center (CHC) ALONG with one of the 4 different behavior change communication (BCC) interventions:
Establishment of PMU, PMC, PDK plus community orientation of doctors, Auxiliary Nurse Midwifery (ANMs) and Accredited Social Health Activist (ASHA) workers Strengthening the capacity CHCs, Primary Health Centre (PHC) and Sub Centre (SC) for the management of CAP will result in better delivery of pneumonia specific care; this will build community’s trust in the public health system
Summary
Prospective community based open labeled behavioral trial (2 by 2 factorial design) conducted in 8 rural blocks of Lucknow district. Community survey will be done by multistage cluster sampling to collect information on changes in types of health care providers’ service utilization for ARI/CAP pre and post intervention
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