Trial reportBMC health services research2016
Health workers' perspectives, knowledge and skills regarding community case management of childhood diarrhoea and pneumonia: a qualitative inquiry for an implementation research project "Nigraan" in District Badin, Sindh, Pakistan.
Trial report in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 26 citations in OpenAlex.
- "A child with severe pneumonia cannot feed, causing malnutrition": exploring health worker and caregiver perspectives and practices for mitigating malnutrition among children with severe pneumonia, a case of Uganda.BMC health services research · 2025Article
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- Practical integrated healthcare prevention and management of children's health quality of respiratory functions: a systematic review.BMJ public health · 2025Article
- Article
- Predictors and disparities in neonatal and under 5 mortality in rural Pakistan: cross sectional analysis.The Lancet regional health. Southeast Asia · 2023Article
- Infection preparedness of community health workers: implications for maternal and neonatal health services in Pakistan.Primary health care research & development · 2022Article
- Exploring the challenges in the management of childhood pneumonia-qualitative findings from health care providers from two high prevalence states in India.PLOS global public health · 2022Article
- Navigating sociocultural disparities in relation to infection and antibiotic resistance-the need for an intersectional approach.JAC-antimicrobial resistance · 2021Review
- Article
- Ongoing training of community health workers in low-income andmiddle-income countries: a systematic scoping review of the literature.BMJ open · 2018Article
- Article
- Exploring health care seeking knowledge, perceptions and practices for childhood diarrhea and pneumonia and their context in a rural Pakistani community.BMC health services research · 2018Article
- Sudden Arrhythmic Death During Exercise: A Post-Mortem Genetic Analysis.Sports medicine (Auckland, N.Z.) · 2017Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundPakistan's Lady Health Worker Programme aims to provide care to children sick with pneumonia and diarrhoea, which continues to cause 27 % under-five mortality in Pakistan. The quality of supervision received by Lady Health Workers (LHWs) in the programme influence their knowledge and skills, in turn impacting their ability to provide care.
methodsThis study is part of an implementation research project titled "Nigraan" (an Urdu word meaning supervisor), and explores LHW and Lady Health Supervisor (LHS) perspectives regarding the role of supervision in improving LHWs performance and motivation in district Badin, Sindh, Pakistan. Their knowledge and skills regarding integrated community case management (iCCM) of diarrhoea and pneumonia were also assessed. Fourteen focus group discussions and 20 in-depth interviews were conducted as part of this qualitative inquiry. Analysis was done using QSR NVivo version 10.
resultsMost LHWs and LHSs identified pneumonia and diarrhoea as two major causes of death among children under-five. Poverty, illiteracy, poor hygiene and lack of clean drinking water were mentioned as underlying causes of high mortality due to diarrhoea and pneumonia. LHWs and LHSs gaps in knowledge included classification of dehydration, correctly preparing ORS and prescribing correct antibiotics in pneumonia. Lack of training, delayed salaries and insufficient medicines and other supplies were identified as major factors impeding appropriate knowledge and skill development for iCCM of childhood diarrhoea and pneumonia. LHWs considered adequate supervision and the presence of LHSs during household visits as a factor facilitating their performance. LHWs did not have a preference for written or verbal feedback, but LHSs considered written individual feedback to LHWs to be more useful than group and verbal feedback.
conclusionLHWs have knowledge and skill gaps that prevent them from providing effective care for diarrhoea and pneumonia. Enhanced supportive feedback from LHSs could improve LHWs skills and performance.
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