Title: Care-seeking practices of and barriers to care-seeking for pneumonia in children aged less than five years in tribal and non-tribal rural areas of Pune district, India.

Funder/Sponsor :The University of Edinburgh.

Objective:This study is ongoing in Manchar area. (PhD Study). The objective of this study is to estimate the proportion of illness episodes with signs and symptoms of pneumonia in the past three months in children under five years of age, for which health-care was sought from any health-care provider in tribal and non-tribal rural areas in Pune district, India. Pneumonia is a leading killer of children globally and India, contributing to 17% - 20% of all under-five deaths. A large proportion of children die because care-givers are unable to seek appropriate care for various reasons. Few Indian studies reported proportions ranging from 65% to 90% for care-seeking for childhood pneumonia. A population-based survey will be conducted among households with children aged between 2-59 months in above-mentioned areas in Pune district. Parents will be administered a questionnaire to obtain information about specific signs and symptoms related to pneumonia with duration and progress, care-givers visited and their characteristics. Data will be collected on gender of child, perceived severity of illness and urgency to seek care, financial barriers, availability of healthcare providers, access to healthcare providers, perceived quality of care, reason for provider preference, level of care, i.e. hospitalization or outpatient care among others. Additionally, data will also be collected about treatment including details of medicines, parenteral fluids, supportive measures like oxygen, hospitalization and/or outpatient treatment. Care-givers of 400 children will be randomly selected for interviews in both the study areas, thus resulting in a total sample size of 800. This study will describe the care-seeking practices for signs and symptoms of childhood pneumonia and try to identify barriers to this. This may lead to developing relevant interventions to bridge the gap between onset of pneumonia and care-seeking.

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