Evidence on community-based intervention for tackling childhood pneumonia Project in Bangladesh

In Bangladesh, pneumonia is a major cause of child mortality, killed 26,766 under 5 children, accounting for 24% of all under 5 child deaths in 2022. To address this issue, we implemented a community-based project in Barishal from June 2021 to December 2022. Project activities aimed to strengthen the health system for improved access and utilization of quality child health care and child immunization services, encouraged community practice and behavior for care-seeking and exclusive breastfeeding. During the project period, 22 medical doctors, 30 paramedics and 168 MoHFW employed service providers including community clinics, community-based health facility for six thousand population, received case management training, 38 health centers were equipped with necessary logistics and supplies for improved case management of sick children. We also conducted special vaccination campaigns in 13 hard-to-reach areas, deployed 11 vaccination aids for improving child vaccination coverage in remote areas and raised awareness of recommended health practices at the community level. A comparison of baseline and endline survey data showed significant improvements in children among 12-23 months of age who received all recommended basic vaccines by 12 months [77% in baseline (n = 239) vs. 92% in endline (n = 235); p < 0.01]; care-seeking from health facilities or trained health service providers for sick children with pneumonia [40% in baseline (n = 127) vs. 52% in endline (n = 225); p < 0.005]; and exclusive breastfeeding for children below 6 months [52% in baseline (n = 122) vs. 62% in endline (n = 120); p < 0.01]. These results revealed the project's success with simple but contextualized efforts to enhance the health system by developing the capacity and skills of service providers to provide high-quality child health care for sick children, improving access to equitable child immunization, and raising social awareness through partnerships with the MoHFW and community engagement initiatives. KEY MESSAGES: • Community-based intervention with minimum resources have potential to scale up with improving accessibility and utilization of health services, specially in hard to reach areas in Bangladesh. • Contextualized and simple intervention through collaboration with local government and community engagement is critical for success of community based health system strengthening project.