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Abstract
Objective Delays in seeking medical attention for childhood pneumonia may lead to increased morbidity and mortality. This study aimed at identifying the drivers of delayed seeking of treatment for severe childhood pneumonia in rural Bangladesh.
Methods We conducted a formative study from June to September 2015 in one northern district of Bangladesh. In-depth interviews were conducted with 20 rural mothers of children under 5 years with moderate or severe pneumonia. We analysed the data thematically.
Results We found that mothers often failed to assess severity of pneumonia accurately due to lack of knowledge or misperception about symptoms of pneumonia. Several factors delayed timely steps that could lead to initiation of appropriate treatment. They included time lost in consultation with non-formal practitioners, social norms that required mothers to seek permission from male household heads (eg, husbands) before they could seek healthcare for their children, avoiding community-based public health centres due to their irregular schedules, lack of medical supplies, shortage of hospital beds and long distance of secondary or tertiary hospitals from households. Financial hardships and inability to identify a substitute caregiver for other children at home while the mother accompanied the sick child in hospital were other factors.
Conclusions This study identified key social, economic and infrastructural factors that lead to delayed treatment for childhood pneumonia in the study district in rural Bangladesh. Interventions that inform mothers and empower women in the decision to seek healthcare, as well as improvement of infrastructure at the facility level could lead to improved behaviour in seeking and getting treatment of childhood pneumonia in rural Bangladesh.
- qualitative research
- health services research
- mortality
- paediatrics
- child health services
Data availability statement
Data are available on reasonable request. Access to field notes and anonymized printed transcripts of the interviews will be restricted to individuals granted permission by the corresponding author, for the purposes of future research.
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Data availability statement
Data are available on reasonable request. Access to field notes and anonymized printed transcripts of the interviews will be restricted to individuals granted permission by the corresponding author, for the purposes of future research.
Footnotes
Contributors KIAC, ASGF, NHA, and HS contributed to the conception and design of the study, carried out the data collection, analysis, drafted the manuscript and proofed the final manuscript as submitted. IJ and MR mainly contributed to data collection and analysis and drafted the manuscript. Contributions to input on initial data analysis and substantial guidance and input for developing the manuscript were given by SA, TA, GJF, TD and NG.
Funding This work was supported by UBS Optimus Foundation, Switzerland and UNICEF, Switzerland grant numbers (GR-01269 and GR-01083).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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