Incidence, healthcare-seeking behavior and barriers associated with seeking care for severe childhood pneumonia in rural Bangladesh: A prospective study.

Globally, childhood pneumonia is one of the leading causes of under-five mortality especially in low-and middle-income countries. This study aimed to estimate the incidence, healthcare-seeking behavior, and barriers associated with seeking care for children suffering from severe pneumonia in rural Bangladesh. A prospective study was conducted in two districts at 81 randomly selected villages in rural Bangladesh. We collected data on 12,303 under-five children between 1st June 2018 to October 2019. Among surveyed children, a total of 154 severe pneumonia cases were recorded, resulting in an overall incidence of 1.3%. When seeking healthcare for their children, most (44.2%) mothers/caregivers availed the health care services from nearby pharmacies or local healthcare providers, followed by Health and Family Welfare Centre (37.0%), private clinics (23.4%), district hospitals (23.4%) health complexes (22.1%). Only 2% sought care at community clinics. Approximately 25% (n=38) of caregivers reported barriers to accessing healthcare. Among those who reported barriers, 39.5% cited an inability to find transportation as the main issue, followed by 26.3% who mentioned high cost of treatment, 10.5% who faced natural calamities including floods, and 2.6% who encountered political instability including strike. The incidence of severe pneumonia was below 2% in our rural areas of Bangladesh. Pharmacies and local healthcare providers were the most commonly used sources for care-seeking. Notable barriers to care-seeking included the lack of available transportation and the high cost of treatment.