Effect of promotion of care-seeking for Acute Respiratory Infections (ARI) Needing Assessment (ANA) on the utilisation of lady health workers services for the management of acute respiratory infections among children aged zero to 59 months in district Haripur, Pakistan

• Register: ISRCTN
• Last refreshed on: 13 January 2015
• Main ID: ISRCTN10618300
• Date of registration: 09/10/2006
• Prospective Registration: No
• Primary sponsor: World Health Organization (WHO) (Switzerland)
• Public title: Effect of promotion of care-seeking for Acute Respiratory Infections (ARI) Needing Assessment (ANA) on the utilisation of lady health workers services for the management of acute respiratory infections among children aged zero to 59 months in district Haripur, Pakistan
• Date of first enrolment: 01/10/2006
• Target sample size: 85481
• Recruitment status: Completed
• URL: http://isrctn.com/ISRCTN10618300
• Study type: Interventional
• Study design: Randomised trial (Treatment)

Countries of recruitment

Pakistan

Contacts

• Name: Shamim Ahmad Qazi

Key inclusion & exclusion criteria

Inclusion criteria: For improving careseeking practices component, mothers of all zero to 59 months old children in the 28 union councils of District Haripur. For the ARI standard case management component, children up to 59 months of age.
Exclusion criteria: 1. Mothers who refuse to take part in the careseeking components
2. Children with pneumonia, whose mother/parents refuse to accept ARI case management by the LHW and those who have danger signs like:
2.1. Inability to drink
2.2. Difficult to awake/drowsy/unconscious
2.3. Grunting
2.4. Cyanosis
2.5. Convulsions
2.6. Severe respiratory distress

Age minimum:
Age maximum:
Gender: Not Specified

Health Condition(s) or Problem(s) studied

Pneumonia and severe pneumonia in children zero to 59 months old.
Infections and Infestations
Pneumonia

Intervention(s)

1. Sensitisation workshop/seminar at district level of district officials and elected representatives on ARI - once at the start of the trial
2. Sensitisation workshop/seminar on ARI at community level at Rural Health Center level - two in a year
3. Training of Lady Health Workers (LHW) on ARI counselling skills and ARI case management - once at the start of the trial
4. Orientation of male activists in communications skills and use of Information Education and Communication (IEC) material - once at the start of the trial
5. Community Awareness Sessions (CAS) at mohalla level for males and females once every month and household visits (five to seven houses) by LHW daily

Of 28 clusters, LHWs in 14 clusters will be randomised to enhanced ARI case management training, which will include management of non-severe and severe pneumonia under supervision and LHWs in the other 14 clusters will be randomised to the standard ARI case management, which will only include management of non-severe pneumonia working in those clusters - once at the start of the trial. One Union council in the district is one cluster.

The Principal Investigator for this trial is:
Dr Abdul Bari
Save the Children US
House No. 5, Street No. 29
Sector F-7/1, Islamabad
Pakistan
Telephone: [phone]/ext. 106
Email: [e-mail]

Primary Outcome(s)

To see the proportionate change in care-seeking by mothers and care-takers for ANA among children zero to 59 months old. This change in care-seeking will be assessed for both from LHW and other appropriate health care providers.

Secondary Outcome(s)

1. To compare the enhanced ARI case management with standard ARI case management for the clinical outcome (cure or failure) for the management of pneumonia at the community level in children up to 59 months old
2. The signs and symptoms used by LHW to classify the ARI in children
3. Compliance by the mother to LHW referral to nearest public health facility
4. Outcome of the referral

Secondary ID(s)

NCH06001

Source(s) of Monetary Support

The Department of Child and Adolescent Health (CAH)/World Health Organisation (WHO) (Switzerland) (ref: NCH06001)