Pneumonia and diarrhoea are two of the leading causes of mortality among children under 5 years in India accounting for 14% and 10% of deaths respectively. In Uttar Pradesh, with a high under five mortality rate, this likely represents a large number of deaths which could be prevented with implementation of known interventions for the treatment of pneumonia and diarrhoea. These interventions are key components of the Global Action Plan for Pneumonia and Diarrhoea (P&D) which provides strategies for protecting, preventing and treating pneumonia and diarrhoea.
The Pneumonia and Diarrhoea (P & D) Project of the IHAT UP- TSU intends to reduce under 5 mortality in Uttar Pradesh through improving the quality of community level and primary facility level management of childhood pneumonia and diarrhoea.
It is currently being implemented in 3 districts – Allahabad, Bareilly and Gonda of Uttar Pradesh.
Improved treatment and referral of childhood pneumonia and diarrhoea by public frontline workers (FLWs) resulting in a decreased case fatality rate.
The IHAT UP TSU is supporting the public FLWs (ASHAs, ANMs, and AWWs) to improve the quantity and quality of their interactions with the households. The TSU is ensuring provision of job aids and methods to improve outreach planning, the quality of home visits, identification of newborn and childhood illnesses and the linking of the community with available services.
On-site mentoring of the FLWs is provided through a network of 3 community resource persons per TSU focused block. The TSU has designed and is implementing the use of the Enumeration and Tracking Tool (ETT) among ASHAs that acts as a job aid to map the number of children in their areas and also to create action plans to ensure mothers receive essential counseling on newborn and childhood health and danger signs to ensure children receive essential health services as per government guidelines and to ensure that unwell children are treated by the appropriate level of care
Improved treatment and referral of childhood pneumonia and diarrhoea by private frontline workers (FLWs) resulting in a decreased case fatality rate.
IHAT TSU strategically identify and engage with high-volume private FLWs who are a first level of contact for households seeking treatment for childhood pneumonia and diarrhoea. Ongoing supportive supervision, concurrent monitoring of data and the development of innovative incentive programs in conjunction with the GoUP is conducted to ensure a sustainable model of quality care provided in the community by private FLWs to children under five with pneumonia and diarrheal disease
Improved treatment and referral of childhood pneumonia and diarrhoea by Block facility staff resulting in a decreased case fatality rate
The IHAT TSU engages with the nurse mentors in blocks as well as the Medical Officers in Charge (MOICs) and additionally provide capacity management support at the district level. Referral systems are also being improved at the Block level facilities for those children requiring tertiary support for management of severe pneumonia and diarrhoea. The number of children managed at the block level facilities as well as their disease severity and demographic characteristics are tracked in order to determine how these facilities are being used and what gaps remain in the appropriate referral and management of children with pneumonia and diarrhea at block level facilities.
A.Oral Rehydration Solution (ORS) and Zinc corners are now functioning well in at least 1/3 of intervention CHCs. In Bhamora CHC, >40 children completed plan B for diarrhoea with some dehydration in August 2016.
B. From 0%, now 33% of intervention CHCs have essential drugs and supplies, 73% have essential infrastructure and 67% provide essential child health services.
C. The project has also supported in training and capacity building of doctors on management of childhood illnesses. As part of the project, the number of medical doctors trained in F-IMNCI (Facility-based Integrated Management of Neonatal and Childhood Illness) has increased from 11% to 36%.