Nair N Sreekumaran, Lewis Leslie Edward, Lakiang Theophilus, Godinho Myron Anthony, Murthy Shruti, Venkatesh Bhumika T
Department of Statistics and Public Health Evidence South Asia (PHESA), Manipal University, Manipal, Karnataka, India.
Department of Pediatrics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
BMJ Open. 2017 Sep 29;7(9):e017403. doi: 10.1136/bmjopen-2017-017403.
India accounted for more neonatal deaths (estimated at 696 000) than any other country, as of 2015. Of these , most neonatal deaths due to infections can be attributed to pneumonia which accounts for 16% of all neonatal mortalities (2010). Despite simple, inexpensive case management strategies being available, pneumonia continues to cause significant mortality and morbidity among neonates. Understanding the perceptions and experiences of stakeholders of neonatal care can help find solutions to barriers to care and design tailored strategies for controlling neonatal pneumonia.
A pan-India qualitative study will be conducted. Participants include healthcare providers, programme officers, academicians, representatives of non-governmental organisations/bilateral agencies and policy makers. They will be recruited purposively from rural and urban, public and private, and facility and community healthcare settings across six Indian regions. Within each region, a minimum of one state will be selected. Districts will be based on neonatal mortality indicators, and will be subject to feasibility at the time of conducting the study. We plan to conduct in-depth interviews (IDI) and focus group discussions focusing on (a) burden, (b) risk factors, (c) case management, (d) treatment guidelines, (e) barriers to case management, (f) recommendations. The number of interviews will depend on the information saturation. Interviews will be audio-recorded with prior written consent and transcribed verbatim. Principles of thematic analysis will be applied for qualitative data analysis using R package for Qualitative Data Analysis (RQDA).
The protocol has been approved by the Health Ministry Screening Committee, Government of India and the Institutional Ethics Committee at the host institution. Confidentiality and privacy of the participants will be maintained. The findings of the study will be shared with all stakeholders of this research including the participants. Knowledge dissemination workshops will be conducted to ultimately transfer the evidence tailored to the stakeholders' need.
截至2015年，印度的新生儿死亡人数（估计为69.6万）比其他任何国家都多。其中，大多数因感染导致的新生儿死亡可归因于肺炎，肺炎占所有新生儿死亡人数的16%（2010年）。尽管有简单、廉价的病例管理策略，但肺炎继续在新生儿中导致大量死亡和发病。了解新生儿护理利益相关者的看法和经历有助于找到护理障碍的解决方案，并设计针对性的策略来控制新生儿肺炎。
将在全印度开展一项定性研究。参与者包括医疗保健提供者、项目官员、学者、非政府组织/双边机构代表和政策制定者。将从印度六个地区的农村和城市、公立和私立、机构和社区医疗保健机构中有目的地招募他们。在每个地区，至少选择一个邦。地区将根据新生儿死亡率指标来确定，并在开展研究时考虑可行性。我们计划进行深入访谈（IDI）和焦点小组讨论，重点关注（a）负担，（b）风险因素，（c）病例管理，（d）治疗指南，（e）病例管理障碍，（f）建议。访谈次数将取决于信息饱和程度。访谈将在获得事先书面同意后进行录音，并逐字转录。将应用主题分析原则，使用定性数据分析R包（RQDA）对定性数据进行分析。
该方案已获得印度政府卫生部筛查委员会和主办机构的机构伦理委员会批准。将维护参与者的保密性和隐私。研究结果将与本研究的所有利益相关者（包括参与者）分享。将举办知识传播研讨会，最终根据利益相关者的需求传递相关证据。
