Detection and management of pneumonia by community health workers - A community intervention study in Rehri Village, Pakistan

This community based, case management intervention study was done to assess the effectiveness of Community Health Workers (CHWs) in case detection and management of pneumonia in children under five years of age.Twenty-two volunteers (school teachers and students) were selected as CHWs from Rehri village, in Sindh, Pakistan and trained on World Health Organization (WHO) recommended National/Acute Respiratory Tract Infection (ARI) guidelines at the Department of Paediatrics, Dow Medical College, Ciyil Hospital, Karachi. The CHWs had no prior health education. The intervention was the use of CHWs to detect and manage pneumonia in children under five years of age in Rehri village. Two medical officers supervised the post-training activities of CHWs in the village during the study period. Between December, 1992 and May, 1993, 442 episodes of pneumonia (very severe disease 10, severe pneumonia 54 and simple pneumonia 378) were detected and managed by trained CHWs. The medical officers agreed with the CHWs for classification and treatment in 356 (81%) cases. This study suggests that in areas where there is a shortage of trained health care professionals, educated community members such as school teachers can be trained to detect and manage pneumonia in their community (JPMA 47:42, 1997).