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

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

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

Conditions
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Pneumonia, Diarrhea, Fever

Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 2 Months
Maximum Age: 59 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | 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 | Measure Description | 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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pneumonia, Fever, Diarrhoea