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Optimizing Care-Seeking for Childhood Pneumonia: A Public Health Perspective

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Abstract

Objective

This study examined the pattern of care-seeking behavior for childhood pneumonia and factors influencing it, in Madhya Pradesh (MP), Uttar Pradesh (UP) and Tamil Nadu (TN).

Methods

Using a mixed-methods design, consenting mothers of children less than 5 years with probable pneumonia participated in a household survey to assess their care-seeking behavior. A purposively selected sub-sample participated in semi-structured interviews (SSIs) to understand their perceptions on care sought, decision making abilities and cultural influences that governed these behaviors. Health care providers (HCPs) participated in SSIs and focus group discussions.

Results

A total of 2194 children were identified with probable pneumonia during the survey. 40 mothers and 41 HCPs participated in semi-structured interviews and focus group discussions. In MP, utilization of private allopathic care was high at 74%, about 8% went to unqualified care providers. In UP, 71% went to unqualified care providers and 5% did not seek care at all. In TN, 75% went to private allopathic doctors, and utilization of government care was higher (19%) compared to MP and UP. Qualitative findings revealed that cultural beliefs coupled with poor decision making abilities, poor understanding of illness and inappropriate care-seeking practices resulted in delays in care seeking, particularly in MP and UP. Inadequacies in government health infrastructure also contributed to their poor utilization.

Conclusion

Promoting health literacy in communities and strengthening the reach of government health facilities will help in optimizing appropriate health care utilization for childhood pneumonia.

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Acknowledgements

Dr Rema Devi for her valuable comments on the paper. Dr BR Desikachari for the continued advice and support he provided throughout the study. Dr Manoj Kumar Das, Director Projects, The INCLEN Trust International, New Delhi for his technical inputs provided during the conduct of the study. We thank the Directorates of Public Health in the states of Madhya Pradesh, Uttar Pradesh and Tamil Nadu for enabling the conduct of the study in the selected government health facilities.

Funding

Funding: This work was supported by Bill and Melinda Gates Foundation through The INCLEN Trust International (Grant number: OPP1084307). The funding source had no contribution in study design, implementation, collection and interpretation of data and report writing. Competing interests: Non stated.

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Authors and Affiliations

  1. Samarth, No. 100 Warren Road, Mylapore, Chennai, Tamil Nadu, 600 004, India

    Shuba Kumar, Rani Mohanraj & Saradha Suresh

  2. Department of Paediatrics, AIIMS, Bhopal, Madhya Pradesh, India

    Bhavna Dhingra

  3. Upgraded Department of Community Medicine and Public Health, KG Medical University, Lucknow, Uttar Pradesh, India

    Monika Agarwal

Authors
  1. Shuba Kumar
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  2. Rani Mohanraj
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  3. Bhavna Dhingra
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  4. Monika Agarwal
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  5. Saradha Suresh
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Corresponding author

Correspondence to Shuba Kumar.

Ethics declarations

Institutional Human Ethics Committee, AIIMS, Bhopal; No. IHEC-LOP/2015/EF0022, dated September 21, 2015. King George’s Medical University, KGMU; No. 7297/Ethics/R.Cell-15; dated September 19, 2015. Samarth Institutional Ethics Committee; No. IEC/003, dated April 18, 2015.

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Additional material related to this study is available with the online version at www.indianpediatrics.net

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Kumar, S., Mohanraj, R., Dhingra, B. et al. Optimizing Care-Seeking for Childhood Pneumonia: A Public Health Perspective. Indian Pediatr 58, 1030–1035 (2021). https://doi.org/10.1007/s13312-021-2368-2

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  • DOI: https://doi.org/10.1007/s13312-021-2368-2

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