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Effect of Behavior Change Communication on the Incidence of Pneumonia in Under Five Children: A Cluster Randomized Controlled Trial

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Abstract

Background

Improving health education of the mother by providing community-based interventions is known to help control pneumonia.

Objective

To determine the effect of behavior change communication (BCC) activities for mothers in reducing the incidence of childhood pneumonia.

Design

Open-label cluster randomized controlled trial.

Setting

Urban slums and villages in two districs of Maharashtra.

Participants/Cluster

Under-five children and their mothers from households in the randomly selected 16 clusters out of total 45 clusters, stratified into Pune and Sangli districts and further into rural and urban areas before randomization.

Intervention

Three forms of BCC activities were imparted, viz., interactive sessions of education using pictorial mothers’ booklet, screening of a audio-visual film, and virtual hand wash demonstration and use of flashcard. Routine care under the National health program was provided by the Accredited Social Health Activists (ASHA) workers in both the arms.

Outcome

The primary outcome was pneumonia as per the IMNCI criteria assessed during fortnightly visits of the ASHA/anganwadi workers to the houses of under-five children, who received at least one follow-up visit in a period of one year.

Results

The incidence of pneumonia in 1993 and 1987 under-five children in the intervention and control arm was 0.80 and 0.48 episodes per child per year, respectively (P=0.03).

Conclusion

BCC for mothers is not sufficient to reduce the incidence of childhood pneumonia.

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Acknowledgments

Dr Nandini Malshe for her technical inputs.Mrs. Aruna Deshpande, Mr Sane, Statistical consultant; Mrs. Mahima Dwivedi and Dr. Supriya Phadnis, Project coordinators for their inputs in project implementation and report compilation; Dr. V N Karandikar, Ex-Director Health Sciences of Bharati Vidyapeeth University Pune; Dr. Manoj Das, INCLEN Trust International for technical guidance.

Funding

Funding: This work was supported by Bill and Melinda Gates Foundation through The INCLEN Trust International (Grant number: OPP1084307). The funding source had no contribution in study design, implementation, collection and interpretation of data and report writing. Competing interest: None stated.

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Authors and Affiliations

  1. Department of Community Medicine, Bharati Vidyapeeth Deemed to be University Medical College, Off Pune Satara Road, Pune, Maharashtra, 411 043, India

    Jayashree Gothankar, Prasad Pore, Prakash Doke, Sujata Murarkar K, Reshma Patil & Sonali Palkar

  2. Department of Pediatrics, Bharati Vidyapeeth Deemed to be University Medical College, Pune, India

    Sanjay Lalwani

  3. Department of Community Medicine, Bharati Vidyapeeth Deemed to be University Medical College and Hospital, Sangli, Maharashtra, India

    Girish Dhumale, Sanjay Quraishi, Vivek Waghachavare, Randhir Dhobale & Kirti Rasote

Authors
  1. Jayashree Gothankar
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  2. Prasad Pore
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Contributions

JG, PD, PP, GD, SL: conceptualization; JG, PP, GD: data curation; JG, PP, GD, PD: formal analysis; JG, SK, PD: funding acquisition; JG, PD, PP, GD: methodology; JG, GD, PP, SP: project administration; SL, JG, PD: resources; PP, VW: software; SQ, SM, RP, VW, RD, KR, SP: supervision; JG, PD, SL: validation; JG, PP: writing — original draft preparation; JG, PD: Writing — review and editing. All authors approved the final version of manuscript, and are accountable for all aspects related to the study.

Corresponding author

Correspondence to Jayashree Gothankar.

Ethics declarations

Bharati Vidyapeeth Deemed University Institutional Ethics Committee; No. ECR/313/Inst/MH/2013/RR-16 dated February 16, 2015. Bharati Vidyapeeth Deemed University Medical College and Hospital IEC, Sangli; No. ECR/276/Inst/MH/2013/RR-16 dated March 01, 2015.

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Additional material related to this study is available with the online version at www.indianpediatrics.net

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Gothankar, J., Pore, P., Dhumale, G. et al. Effect of Behavior Change Communication on the Incidence of Pneumonia in Under Five Children: A Cluster Randomized Controlled Trial. Indian Pediatr 58, 1046–1051 (2021). https://doi.org/10.1007/s13312-021-2371-7

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  • DOI: https://doi.org/10.1007/s13312-021-2371-7

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