Use of a pneumonia management tool to manage children with pneumonia at the first level health care facilities.
OBJECTIVE
To describe the application and evaluation of Pneumonia Management Tool (PMT) to manage children with non-severe pneumonia (NSP) at the first level health care (FLHC) facilities according to the standard case management (SCM) guidelines for acute respiratory infections (ARI).


METHODS
The ARI SCM guidelines were simplified to a PMT and used by health workers at 14 FLHC facilities to assess, manage and monitor children with NSP and to educate caretakers on home care and follow-up visits. The district supervisors provided on the job support to various cadres of health workers of both public and private facilities.


RESULTS
Of 949 children with NSP, 940 (99%) were successfully treated at FLHC facilities. Caretakers found PMT useful and of 1888 follow-up visits: 1872 (99.2%) brought PMT copy; 1627 (86.2%) brought their children to the facility; 1799 (95.3%) were on time and; 1857 (98.4%) had maintained antibiotic compliance. Using PMT, health workers adherence to SCM guidelines improved from 14% at baseline to 29% after training and 65% with on the job support. The practices remained similar among various cadres of health workers.


CONCLUSIONS
Health workers used PMT in managing children with NSP, counselling caretakers on home care, follow-up visits and monitoring the treatment outcome. District level supervision helped to maintain a uniform skill enhancement.
Aga Khan Foundation, Islamabad.
Qayyum Ali
QA
Noorani
Shamim Ahmed
SA
Qazi
Zeba A
ZA
Rasmussen
Yaqoob
Y
Muhammad
D000328:Adult; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019090:Case Management / Q000592:standards; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006268:Health Facilities / Q000592:standards / Q000706:statistics & numerical data; D006282:Health Personnel; D006801:Humans; D008297:Male; D055118:Medication Adherence; D011014:Pneumonia / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents