From research to national expansion: 20 years' experience of community-based management of childhood pneumonia in Nepal
PROBLEM: Pneumonia is a leading cause of mortality of children aged under five in Nepal. Research conducted by John Snow Inc. in the 1980s determined that pneumonia case management by community-based workers decreased under-five mortality by 28%. APPROACH: Female community health volunteers were sel...
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| Format: | Article |
| Language: | English |
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The World Health Organization
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| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862008000500010&lng=en&tlng=en |
| _version_ | 1797284911747432448 |
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| author | P Dawson YV Pradhan R Houston S Karki D Poudel S Hodgins |
| author_facet | P Dawson YV Pradhan R Houston S Karki D Poudel S Hodgins |
| author_sort | P Dawson |
| collection | DOAJ |
| description | PROBLEM: Pneumonia is a leading cause of mortality of children aged under five in Nepal. Research conducted by John Snow Inc. in the 1980s determined that pneumonia case management by community-based workers decreased under-five mortality by 28%. APPROACH: Female community health volunteers were selected as the national cadre to manage childhood pneumonia at community level using oral antibiotics. A technical working group composed of government officials, local experts and donor partners embarked on a process to develop a strategy to pilot the approach and expand it nationally. LOCAL SETTING: High under-five mortality rates, low access to peripheral health facilities and severe constraints in human resources led Nepal's Ministry of Health to test this innovative approach. RELEVANT CHANGES: Community-based management of pneumonia doubled the total number of cases treated compared with districts with facility-based treatment only. Over half of the cases were treated by the female community health volunteers. The programme was phased in over 14 years and now 69% of Nepal's under-five population has access to pneumonia treatment. LESSONS LEARNED: Community-based management of pneumonia provides a medium-term solution to address a leading cause of child mortality while the efforts continue to strengthen and extend the reach of facility-based care. Trained community health workers can significantly increase the number of pneumonia cases receiving correct case management in resource-constrained settings, with appropriate health systems' support for logistics, supervision and monitoring. Community-based management of pneumonia can be scaled up and provides an effective approach to reducing child deaths in countries faced with insufficient human resources for health. |
| first_indexed | 2024-03-07T17:55:39Z |
| format | Article |
| id | doaj.art-3cd292fc08be4abf98995e71b81664aa |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T17:55:39Z |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-3cd292fc08be4abf98995e71b81664aa2024-03-02T12:27:53ZengThe World Health OrganizationBulletin of the World Health Organization0042-968686533934310.1590/S0042-96862008000500010S0042-96862008000500010From research to national expansion: 20 years' experience of community-based management of childhood pneumonia in NepalP Dawson0YV Pradhan1R Houston2S Karki3D Poudel4S Hodgins5John Snow IncorporatedGovernment of NepalJohn Snow IncorporatedJohn Snow IncorporatedJohn Snow IncorporatedJohn Snow IncorporatedPROBLEM: Pneumonia is a leading cause of mortality of children aged under five in Nepal. Research conducted by John Snow Inc. in the 1980s determined that pneumonia case management by community-based workers decreased under-five mortality by 28%. APPROACH: Female community health volunteers were selected as the national cadre to manage childhood pneumonia at community level using oral antibiotics. A technical working group composed of government officials, local experts and donor partners embarked on a process to develop a strategy to pilot the approach and expand it nationally. LOCAL SETTING: High under-five mortality rates, low access to peripheral health facilities and severe constraints in human resources led Nepal's Ministry of Health to test this innovative approach. RELEVANT CHANGES: Community-based management of pneumonia doubled the total number of cases treated compared with districts with facility-based treatment only. Over half of the cases were treated by the female community health volunteers. The programme was phased in over 14 years and now 69% of Nepal's under-five population has access to pneumonia treatment. LESSONS LEARNED: Community-based management of pneumonia provides a medium-term solution to address a leading cause of child mortality while the efforts continue to strengthen and extend the reach of facility-based care. Trained community health workers can significantly increase the number of pneumonia cases receiving correct case management in resource-constrained settings, with appropriate health systems' support for logistics, supervision and monitoring. Community-based management of pneumonia can be scaled up and provides an effective approach to reducing child deaths in countries faced with insufficient human resources for health.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862008000500010&lng=en&tlng=en |
| spellingShingle | P Dawson YV Pradhan R Houston S Karki D Poudel S Hodgins From research to national expansion: 20 years' experience of community-based management of childhood pneumonia in Nepal Bulletin of the World Health Organization |
| title | From research to national expansion: 20 years' experience of community-based management of childhood pneumonia in Nepal |
| title_full | From research to national expansion: 20 years' experience of community-based management of childhood pneumonia in Nepal |
| title_fullStr | From research to national expansion: 20 years' experience of community-based management of childhood pneumonia in Nepal |
| title_full_unstemmed | From research to national expansion: 20 years' experience of community-based management of childhood pneumonia in Nepal |
| title_short | From research to national expansion: 20 years' experience of community-based management of childhood pneumonia in Nepal |
| title_sort | from research to national expansion 20 years experience of community based management of childhood pneumonia in nepal |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862008000500010&lng=en&tlng=en |
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