Treatment of Pneumonia, Diarrhoea and Fever in Children by Community Health Workers

To Operationalise the Policy of Treating Uncomplicated Pneumonia, Diarrhoea and Fever in Children Aged 2-59 Months by Community Health Workers(CHW)

The investigators propose to test the feasibility and acceptability of community health workers (ASHAs and ANMs) being able to treat sick children in the community. There is a national policy for treatment for children aged 2-59 months with illnesses such as pneumonia, diarrhea and fever by community health workers (CHWs), this policy has not been implemented as yet in Haryana. This research will identify barriers and opportunities for use of CHWs as treatment sources.

Study Overview

• Status: Completed
• Conditions: Pneumonia, Diarrhea, Fever

Detailed Description

Using indepth interviews, focus group discussions and other qualitative research methods barriers and opportunities for promoting use of ASHAs as a treatment source for diarrhea, pneumonia and fever will be identified. An intervention package which includes training of ASHAs and ANMs to treat uncomplicated cases of pneumonia, diarrhea and fever, ensuring they have required supplies, creating awareness in community and monitoring and supervising the treatment provided by them will be implemented in primary health centre areas in Haryana, India. ASHAs will treat cases of fast breathing pneumonia with amoxicillin and refer children with danger signs or chest indrawing pneumonia. Three rounds of cross sectional surveys will be conducted to ascertain prevalence of morbidity, careseeking and hospitalizations in children aged 2 to 59 months.

• Study Type: Observational
• Enrollment (Actual): 24000

Contacts and Locations

Study Locations

• India
  • Haryana
    • Palwal, Haryana, India, 121102
      • CHRD, Society for Applied Studies

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 2 months to 4 years (Child)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The study will be conducted in 2 primary health centres. These include 6 sub centres in Rasoolpur PHC (population ~57000) and 7 sub centres in Mandkola PHC (population ~57000).

Description

Inclusion Criteria:

• Children aged 2-59 months with uncomplicated pneumonia or diarrhoea or fever

Exclusion Criteria:

• Refusal for participation
• Diarrhea with dehydration
• Danger signs
• Chest indrawing pneumonia

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Increase in the proportion of caregivers seeking care for 2-59 months old children with pneumonia, diarrhoea and fever from trained Community Health Workers (CHW)	To be assessed at baseline
Increase in the proportion of caregivers seeking care for 2-59 months old children with pneumonia, diarrhoea and fever from trained Community Health Workers (CHW)	To be assessed 5 months after start of study
Increase in the proportion of caregivers seeking care for 2-59 months old children with pneumonia, diarrhoea and fever from trained Community Health Workers (CHW)	To be assessed 8 months after start of study
Increase in proportion of caregivers seeking care for 2-59 months, old children with pneumonia, diarrhoea and fever from appropriate sources of care.	To be assessed at baseline
Increase in proportion of caregivers seeking care for 2-59 months, old children with pneumonia, diarrhoea and fever from appropriate sources of care.	To be assessed 5 months after start of study
Increase in proportion of caregivers seeking care for 2-59 months, old children with pneumonia, diarrhoea and fever from appropriate sources of care.	To be assessed 8 months after start of study

Secondary Outcome Measures

Outcome Measure	Time Frame
Knowledge and perceptions of caregivers about treatment from trained CHWs assessed by indepth interviews and focus group discussions	To be assessed at baseline
Knowledge and perceptions of caregivers about treatment from trained CHWs assessed by indepth interviews and focus group discussions	To be assessed 5 months after start of study
Knowledge and perceptions of caregivers about treatment from trained CHWs assessed by indepth interviews and focus group discussions	To be assessed 8 months after start of study
Experiences of CHW about themselves as treatment providers assessed by indepth interviews using questionnaires	To be assessed at baseline
Experiences of CHW about themselves as treatment providers assessed by indepth interviews using questionnaires	To be assessed 5 months after start of study
Experiences of CHW about themselves as treatment providers assessed by indepth interviews using questionnaires	To be assessed 8 months after start of study
Perceptions and experiences of caregivers belonging to disadvantaged section of the community who could not access treatment from CHWs assessed by using questionnaires, indepth interviews	To be assessed at baseline
Perceptions and experiences of caregivers belonging to disadvantaged section of the community who could not access treatment from CHWs assessed by using questionnaires, indepth interviews	To be assessed 5 months after start of study
Perceptions and experiences of caregivers belonging to disadvantaged section of the community who could not access treatment from CHWs assessed by using questionnaires, indepth interviews	To be assessed 8 months after start of study
Proportion of caregivers who complied with referral.	To be assessed at baseline
Proportion of caregivers who complied with referral.	To be assessed 5 months after start of study
Proportion of caregivers who complied with referral.	To be assessed 8 months after start of study
Proportion of children treated by ANMs with injectable antibiotics.	To be assessed at baseline
Proportion of children treated by ANMs with injectable antibiotics.	To be assessed 5 months after start of study
Proportion of children treated by ANMs with injectable antibiotics.	To be assessed 8 months after start of study
Proportion of times of families who tried to contact CHW and were unable to do so.	To be assessed at baseline
Proportion of times of families who tried to contact CHW and were unable to do so.	To be assessed 5 months after start of study
Proportion of times of families who tried to contact CHW and were unable to do so.	To be assessed 8 months after start of study

Collaborators and Investigators

• Sponsor: Society for Applied Studies
• Collaborators: World Health Organization
• Investigators: Principal Investigator: Sarmila Mazumder, MBBS, PhD, Centre for Health Research and Development, Society for Applied Studies

Study record dates

Study Major Dates

• Study Start: November 1, 2015
• Primary Completion (Actual): February 1, 2017
• Study Completion (Actual): February 1, 2017

Study Registration Dates

• First Submitted: November 24, 2015
• First Submitted That Met QC Criteria: December 4, 2015
• First Posted (Estimate): December 7, 2015

Study Record Updates

• Last Update Posted (Actual): September 6, 2018
• Last Update Submitted That Met QC Criteria: September 5, 2018
• Last Verified: September 1, 2018

More Information

Terms related to this study

• Keywords: Pneumonia; Fever; Diarrhoea
• Additional Relevant MeSH Terms: Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Lung Diseases; Signs and Symptoms, Digestive; Body Temperature Changes; Pneumonia; Diarrhea; Fever
• Other Study ID Numbers: 2015/517094-0