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The information contained in this website is for general information purposes only. The information is provided by fightpneumonia.org and while we endeavour to keep the information up to date and correct...
Pneumonia is the leading cause of deaths among children under 5 years of age globally as well as in India. Majority of these deaths can be averted by creating awareness in the community about pneumonia and its danger signs and by promoting and facilitating prompt and appropriate care-seeking. This website provides details of the findings of a project under taken to develop messages which would be used as a part of communication strategy to bring about behaviour change to improve household decision making and care seeking when confronted with lower respiratory tract illnesses in children in northern India. This project was funded by Bill and Melinda Gates Foundation.
This one year project started from September 2013 and was conducted in 14 districts in rural Uttar Pradesh and Bihar. Here, 5 different dialects of Hindi are spoken. We used qualitative research with a mix of various techniques including case studies, key informant interviews, semi-structured interviews, focus group discussions and also used video recordings and clinical scenarios while conducting our interviews. Our informants were parents of children less than 5 years of age who had suffered from a respiratory illness, Community Health Workers and Rural Medical Practitioners.
While symptoms of Pneumonia were described using different terms and different dialects, we found that the English word "pneumonia" was universally recognised and associated with respiratory illness. Therefore, we have used the word Pneumonia for the messages we have developed.We found that 'Fast breathing', which is an early sign of pneumonia, was not commonly recognized. Chest in-drawing was recognized and associated with Pneumonia but parents and caregivers, care providers did not specifically looked for chest in- drawing by removing a child's clothing. Also recognition of danger signs of pneumonia was poor among caregivers.
In terms of care-seeking, we found that most cases perceived of mild to moderate pneumonia were taken to village-based, mostly unqualified, rural medical practitioners, and more severe cases were taken to private clinics in towns nearby. Mothers if required took the child alone for consulting rural medical practitioners. However, decision to visit doctors outside the village mostly required approval by the husband or mother-in-law and mother was always accompanied by the family member. By the time most cases of pneumonia reached a public tertiary care hospital, the child had been ill for a week or more and treated by 2-3 practitioners by a variety of drugs which included Oral and Injectible antibiotics, Cortico steroids, Broncho- dilators and anti pyretic. We found that quality of care at government health facilities was perceived to be poor by the caregivers.
We concluded that to reduce child mortality from pneumonia in this area, the community must recognise pneumonia early by understanding that fast breathing is an early sign of Pneumonia and also its danger signs. They should also recognize the danger sign of pneumonia understand the consequences and risks of delaying treatment by a qualified provider and building trust in public health facilities is also the need of this day. Community must be made aware that Government health care facilities have qualified doctors and appropriate drugs and equipment to treat childhood pneumonia.
Thus, with our partner, PointBlank we have developed 5 posters, 5 case studies, 4 audio messages and 3 animated video messages through an inclusive and interactive process. Out of these 5 posters, 3 posters have ultimately been finalised. The messages that have been developed are to:
Promote early recognition of pneumonia
Provide information on when and where to seek care
Promote understanding about the risks associated with delayed treatment and treatment from unqualified provider
All messages are in Hindi (Khari boli) and have been validated in Uttar Pradesh and Bihar for their understand ability. We systematically tested the sensitivity of each message in terms of what actions were prompted by it and what was their social appeal. Thereafter, we customised the messages and the final products are on this website for use by all.
These cross-cutting messages prompt positive affirmative action to save the life of a child with pneumonia. This website gives details of the project, reports the process and results of all phases of the study to ensure that the science which went into the message development could be understood and used by others for Pneumonia or related illnesses. We have also tried to put up other recent and reliable resources on childhood pneumonia. I solicit you to use these materials and feel free to get back to us, in case you have any query. The materials here would be updated from time-to-time.
You or your organization could send requests to me for linking your site with ours.
I urge you to join hands in reducing childhood pneumonia deaths in India.
At last, I conclude with our punch line, "Jetenge hum harega pneumonia."
Prof. Shally Awasthi,
Department of Paediatrics,
King George's Medical University, Lucknow
