Abstract of Dissertation

Keyword : ASHA; Pneumonia; Diarroea; Knowledge; Attitude Practice; KAP

Objective : The objectives of the study were to know the knowledge, attitude and practice of the ASHA for disease identification, treatment and referral for the children suffering from pneumonia and diarrhea and find out the bottlenecks.

Background : To reduce less than five mortality, reduction in the death of a child from pneumonia and diarrhea is a critical event because these two diseases account for 29 % of child death globally. Whereas unfortunately India and among Indian states Uttar Pradesh toll highest child death. ASHA is considered as the link between the community and health facility. To make a huge impact only facility level disease management will not work so community based case management is required essentially.

Methodology : A cross sectional descriptive study was conducted in randomly selected three blocks of district Bareilly Uttar Pradesh. Response of ASHA was captured through interview schedule consisting both open and close ended questions.

It was found that knowledge level of ASHA for pneumonia was poor (29%) as compared to diarrhoea (41%). More specifically knowledge level for diarrhea was found to be low into the following areas- referral signs and tab. zinc usage. On the other hand knowledge level for pneumonia is very low in the following areas sign and symptoms of pneumonia, referral signs and antibiotic usage. In practice section researcher found that overall practice level of ASHA for pneumonia was very low that is 18% as compared to diarrhea which was 46%. While practice level for diarrhoea was low in the three areas that is assessment of diarrhoea, assessment of dehydration and counselling to mothers. For pneumonia, the problems were found in the practice of assessment of pneumonia, treatment of pneumonia and counselling to the mothers. Apart from this some open ended findings revealed availability of medicine was a major problem like field presence of ORS was only 60% while zinc availability to ASHA was only 50 %. There was no medicine available near ASHA to manage childhood pneumonia. The study revealed many gaps in knowledge and practice regarding childhood pneumonia, as maximum number of ASHA was in the below average segment in both area. Though module-7 training has completed recently but the level of knowledge of ASHA is not sufficient hence there is an urgent need to focus on training on pneumonia management and a clear need of intense handholding support. For diarrhea knowledge about the dose of tab. Zinc is to be focused upon the assessment of diarrhea patient and assessment of dehydration is not up to the mark and also need attention. Pneumonia assessment and treatment is a blank field to intervene. While counseling for prevention and protection from both the disease is very low hence it needs attention. Most critical element of disease management is drug availability which is not ensured up to the ASHA level. Refresher trainings of childhood pneumonia and regular discussion on identified gaps on pneumonia management in monthly follow-up meeting. Dissemination of Posters and job aids to remind zinc doses to ASHA. Ensure delivery of ASHA drug kit supply to each ASHA at cluster meetings and its field verification. Eestablishment of a helpdesk by promoting any ASHA Sangini to help all ASHA at referral points.