Awasthi Shally, Verma Tuhina, Agarwal Monica, Pandey Chandra Mani
Department of Pediatrics, King George's Medical University, Lucknow, India.
Department of Community Medicine, King George's Medical University, Lucknow, India.
BMC Pediatr. 2018 Aug 22;18(1):279. doi: 10.1186/s12887-018-1250-4.
Community 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: 1. 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) 2. Organizing PAS on Village Health and Nutrition Day only once a month in villages by Accredited Social Health Activist (ASHA) 3. Combination of both Interventions 1 & 2 4. Usual Care as measured by number of clinical pneumonia cases-treated by ANM/doctors with PDK or treated at either PMC or PMU.
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.
CAP 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.
This study has been registered retrospectively in the AEARCT Registry and the registration number is: AEARCTR-0003137 .
社区获得性肺炎（CAP）是包括印度在内的全球儿童发病和死亡的主要原因。通过提高社区对CAP早期症状的认识，并确保提供全天候的优质医疗服务，可以避免许多此类死亡。目的是评估一项创新方案的有效性，该方案包括让医生和社区卫生工作者了解社区对CAP的看法、寻求合格医疗服务的障碍，以及通过以下方式加强基础设施建设：（i）提供“肺炎药物包”（PDK）；（ii）在新增的初级卫生保健中心（PHC）设立“肺炎管理角”（PMC）；（iii）在社区卫生中心（CHC）设立“肺炎管理单元”（PMU），同时采用以下4种不同的行为改变沟通干预措施之一：1. 由辅助护士助产士（ANM）在PHC和CHC的常规免疫日为5岁以下儿童的照料者组织儿童肺炎认知讲座（PAS）；2. 由经认可的社会健康活动家（ASHA）每月仅在村庄的乡村健康和营养日组织一次PAS；3. 干预措施1和2的组合；4. 以ANM/医生使用PDK治疗的临床肺炎病例数或在PMC或PMU接受治疗的病例数衡量的常规护理。
在勒克瑙区的8个农村街区进行前瞻性基于社区的开放标签行为试验（2×2析因设计）。将通过多阶段整群抽样进行社区调查，以收集干预前后ARI/CAP医疗服务提供者服务利用类型变化的信息。
CAP是全球儿童死亡的主要杀手之一。研究报告称，照料者对肺炎及其危险体征的认识较差。拟议的研究将评估各种沟通策略在改善母亲/社区层面、卫生工作者和卫生中心层面儿童肺炎病例管理干预措施方面的有效性。该项目将产生需求并改善CAP优质护理的供应，从而降低勒克瑙区的死亡率。由于这项工作将与政府合作开展，因此可以扩大规模。
本研究已在AEARCT注册中心进行回顾性注册，注册号为：AEARCTR-0003137 。
