Exploration of Pneumonia Related Policy Formation and Implementation in Pakistan

Aim:To identify and analyze pneumonia related policies in Pakistan for children under five and identify key stakeholders who influence these policies and program financially and technically.Outline of the context:In Pakistan, numerous programs have been launched for management of acute respiratory infections.However, despite completion, state of pneumonia mortality remains unchanged as no sustainable solutions have been yielded by these programs. Description of change:The results of this study will inform policies and program managers to better formulate the policies and program which can be translated into action to reduce pneumonia related morbidity and mortality.Strategy for change:The study is being conducted in two phases. The first was of content analysis of pneumonia related documents and IDI’s of policy stakeholders. Data was analyzed through an integrated approach. The second phase consists of social network research conducted by studying actors linked together by social relations achieved through net mapping exercise. Data will be analyzed through the Organizational Risk Analyzer (ORA).Effects of change:Our study is not completed yet; effects of change will be measured at the end. Lessons learnt:In content analysis only one policy document; National ARI control program exclusively focused on pneumonia. Others included pneumonia as part of major childhood illnesses. Except for ARI and IMNCI, most documents highlighted importance of pneumonia burden, mortality and focused on improving overall capacity building and development of pneumonia management infrastructure. Documents focusing on prevention related strategies emphasized mostly on immunization and hygiene. Pneumonia specific risk factors were not addressed. Policy formulation process included problem identification followed by sensitization of influencers, formulation of working paper, consultative meetings, endorsement and sharing of policy with program managers and implementation through respective programs. Major barriers identified are lack of local ownership of policy, non sustainability once the donors pull out, lack of local funding, lack of coordination between the federal and provincial governments, verticality of the programs and poor implementation. Net mapping phase is underway and findings are yet to be reported.Message for others:Strong stakeholder engagement is the key to success for improving the policy formulation and implementation process. Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Declaration of Interest This research was commissioned by National Institute of Health Research using Official Development Assistance (ODA) funding. The views expressed in this publication are those of author(s) and not necessarily those of NHS, the National Institute of Health Research, or development of Health. References and Clinical Trial Registry Information