A key finding of this major study in Archives of Disease in Childhood is that 'Limited knowledge among caregivers and absence of community-based health education in the district of study might have inhibited early diagnosis of pneumonia and the consequences'. This is consistent with previous studies in other LMICs which have found, for example, that 8 in 10 caregivers in developing countries do not know the two key symptoms of childhood pneumonia - fast and difficult breathing - which indicate the need for urgent treatment, and only 1 in 3 children with pneumonia receive antibiotics - despite wide availability - contributing to more than 2,000 avoidable deaths every day). https://www.hifa.org/about-hifa/why-hifa-needed
Citation and abstract below. CHIFA would be very interested to learn of progress and innovations in meeting the information needs of parents to recognise and take appropriate action to prevent child death from pneumonia.
CITATION: Chowdhury KIA, Jabeen I, Rahman M, et al. Barriers to seeking timely treatment for severe childhood pneumonia in rural Bangladesh. Archives of Disease in Childhood 2022;107:436-440.
ABSTRACT
Objective: Delays in seeking medical attention for childhood pneumonia may lead to increased morbidity and mortality. This study aimed at identifying the drivers of delayed seeking of treatment for severe childhood pneumonia in rural Bangladesh.
Methods: We conducted a formative study from June to September 2015 in one northern district of Bangladesh. In-depth interviews were conducted with 20 rural mothers of children under 5 years with moderate or severe pneumonia. We analysed the data thematically.
Results: We found that mothers often failed to assess severity of pneumonia accurately due to lack of knowledge or misperception about symptoms of pneumonia. Several factors delayed timely steps that could lead to initiation of appropriate treatment. They included time lost in consultation with non-formal practitioners, social norms that required mothers to seek permission from male household heads (eg, husbands) before they could seek healthcare for their children, avoiding community-based public health centres due to their irregular schedules, lack of medical supplies, shortage of hospital beds and long distance of secondary or tertiary hospitals from households. Financial hardships and inability to identify a substitute caregiver for other children at home while the mother accompanied the sick child in hospital were other factors.
Conclusions: This study identified key social, economic and infrastructural factors that lead to delayed treatment for childhood pneumonia in the study district in rural Bangladesh. Interventions that inform mothers and empower women in the decision to seek healthcare, as well as improvement of infrastructure at the facility level could lead to improved behaviour in seeking and getting treatment of childhood pneumonia in rural Bangladesh.
Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org
Working in official relations with WHO
