Understanding the Reasons for Delay in Seeking Care for Pneumonia among Caregivers of Under-Five Children in Selected Communities of Pakistan

Aim: Our aim is to understand the factors responsible for delayed care seeking for pneumonia in selected communities in Pakistan.Brief Outline of Context: Around 36% of deaths due to pneumonia in children under five occur at the level of the household without ever reaching a healthcare provider. Understanding the factors that cause the delay will help in developing interventions involving counselling by LHWs to bring about positive behavior change.Description of Change:A qualitative approach was employed to better understand the complex reality of caregiver perception and factors affecting care seeking. This will be followed by development of a mhealth based feasibility study. Strategy for Change:Qualitative in-depth interviews with mothers of under five children and focus group discussions with fathers and grandmothers of under five children were conducted. Data was collected from respondents residing in urban and rural settings from selected communities in Punjab, KPK, Sindh, Federal and AJK. Collected data was transcribed and translated for thematic analysis.Lessons Learnt Major factors in delayed care seeking are family pressure on mothers to wait and monitor child’s consultation, managing child’s condition at home for at least 24 hours before consulting HCP, use of previously prescribed medicines, dissatisfaction with HCP, no one to accompany and financial limitations. Caregivers perceive pneumonia as a dangerous disease and common symptoms associated with it are cough, fever, pain and congestion in the chest. Majority of them considered exposure to the cold as its main cause including winter season, feeding child cold milk and handling the child with cold hands. Very few caregivers were aware of the importance of danger signs of pneumonia including stridor and chest wall indrawing. Among all caregivers, grandmothers were more aware of the danger signs.Message for others: Strong stakeholder engagement is impactful in overcoming the delay in care seeking. Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Declaration of Interest This research was commissioned by the National Institute of Health Research using Official Development Assistance (ODA) funding. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute of Health Research, or development of Health. References and Clinical Trial Registry Information 1.Salim Sadruddin , Ibad ul Haque Khan , Abdul Bari , Attaullah Khan , Ijaz Ahmad , Shamim A. Qazi.(2015). Effect of community mobilization on appropriate care seeking for pneumonia in Haripur, Pakistan. The Journal of Global Health. doi: 10.7189/jogh.05.010405.