"Adequate measures should be taken to check the misuse of any drug including antibiotics and their irrational use should be prevented at federal and provincial levels", said Dr Assad Hafeez, Director General of Ministry of Health during a seminar, here on Friday.
Save the Children, in collaboration with the National Programme for Family Planning & Primary Health, Ministry of Health, with funding support from World Health Organisation, held a seminar to share the results of a research study conducted on the Cluster Randomized Trial of Community Case Management of Severe Pneumonia with Oral Amoxicillin in Children 2-59 Months of Age in District Haripur, Pakistan.
Dr Iqbal Ahmed Lehri (National Co-ordinator, National Programme for Family Planning and Primary Health Care, Ministry of Health), Dr Tabish Hazir (Associate Professor, Pakistan Institute of Medical Sciences, Islamabad), Dr Zulfiqar A. Bhutta (Professor & Chairman, Department of Pediatrics and Child Health, Aga Khan University), Dr Shamim A. Qazi (World Health Organisation, Geneva, Switzerland), Dr Amanullah Khan (Deputy Country Director, Save the Children US) and Dr Abdul Bari (Senior Manager Health Research, Save the Children US) along with senior representatives from USAID, DFID, AUSAID, UNICEF, WHO, GTZ, CIDA, UNFPA, UNAIDS and other development partners also attended the seminar.
Since early detection and treatment of pneumonia can help reduce mortality in children, the aim of the operational research was to increase the number of children 2-59 months old who were examined by the lady health worker for timely management of pneumonia and severe pneumonia.
The project involved the provision of amoxicillin, training and community mobilisation in district Haripur. The objective of the research was to determine whether enhanced pneumonia case management with amoxicillin delivered by lady health workers in the community will result in the reduction of treatment failure among children 2-59 months of age, compared to the rate of treatment failure in children with pneumonia who are referred to local health facilities as per normal practice by the LHW programme.
A total of 19,221 pneumonia cases have been successfully treated from April 2008 till December 2009 of which 15,749 were pneumonia and 3,472 were severe pneumonia cases.
Dr Iqbal Ahmed Lehri, National Co-ordinator, National Programme for Family Planning and Primary Health, Ministry of Health initiating the seminar acknowledged Save the Children's efforts in combating childhood Pneumonia in Pakistan. He said, "We need to develop a consensus based on best practices as the irrational use of antibiotics by the doctors is very high in Pakistan".
Pneumonia is a forgotten killer of children in Pakistan and results in 1.6 million deaths of under five children annually world-wide, out of which, an estimated 84,000 under five children die due to pneumonia in Pakistan every year. However, recent research in Asia and Africa has shown that trained Community Health Workers can treat non-severe pneumonia well. Training CHWs in treating non-severe pneumonia with oral antibiotic and referring children with severe pneumonia has also been recommended by WHO/UNICEF. As a result of this intervention, there has been 36-42% reduction in pneumonia mortality in research settings and 24-27% reduction in total child mortality in Pakistan.
Dr Abdul Bari, Senior Manager Health Research at Save the Children US, Islamabad presented the study findings of research and shared that there were major improvements in the household knowledge, attitudes and practices of the subjects with remarkable improvements in treatment seeking for AM among children, consultation of Lady Health Workers as health care providers (52.2% as compared to 1.4%), role of mothers in seeking care (71% as compared to 53%), promptness in care seeking for AM (22.4% as compared to 31.8%) and caretakers knowledge of AM symptoms (10% as compared to nil).
Later, Dr Amanuhlah Khan, Deputy Country Director, Save the Children US, addressed all the participants and highlighted the fact that combating Pneumonia has been an area of struggle for Pakistan since the challenge has always been to find a simple solution which doesn't require a big change but can change lives significantly.
Dr Assad Hafeez, Director General Health, Ministry of Health, Government of Pakistan ended the seminar by giving concluding remarks and acknowledged the change that Save the Children has brought about through this study in District Haripur. He thanked the organisation for improving the overall efficiency, equity and effectiveness of the health services throughout Pakistan and expressed that he would look forward to similar endeavours and partnerships with Save the Children in the future. He closed the seminar by stating that the national programme would undertake necessary steps in order to define a mechanism for the long-term continuation of the initiative of eradicating childhood Pneumonia from Pakistan.
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