NIHR Global Health Research Unit on Respiratory Health (RESPIRE)

Understanding the reasons for delay in seeking care for pneumonia

This project is based at Maternal, Neonatal and Child Health Research Network (MNCHRN) in Pakistan


  • Project title: Understanding the reasons for delay in seeking care for pneumonia among caregivers of children under five in Pakistan
  • Acute or chronic:  Acute
  • Based at:  MNCHRN
  • Start date:  15 December 2018
  • End date:  14 March 2020
  • Principal investigator:  Tabish Hazir
  • Project team:  Hana Mahmood, Syed Yahya Sheraz, Hira Kiani, Saman Mujeeb, Omair Sheikh


Pneumonia continues to be the leading cause of morbidity and mortality of children under five in Pakistan. Delayed care seeking is one of the major avoidable causes.

Around 38% of deaths due to respiratory illnesses occur in households due to delayed care seeking, which is defined as delay in care sought for an illness outside home. This could be due to lack of time, lack of funds for healthcare, lack of decision making or improper carer perception and understanding of the seriousness of the condition.

There are various cultural, social, personal and religious factors which affect the care seeking behaviours of caregivers for childhood illnesses including pneumonia. Understanding the major reasons of delayed care seeking is critical for developing effective intervention strategies to reduce disease related mortality. 

Aim and impact

To better understand the factors responsible for delayed care seeking for pneumonia in selected communities in Pakistan in order to develop interventions primarily involving counselling by the Lady Health workers (LHWs) to bring about a positive behaviour change in care seeking for pneumonia in the community settings.

The results of this study will aid in the development of a counselling intervention to bring about a behaviour change in care seeking for pneumonia in order to help reduce childhood deaths due to delayed care seeking for pneumonia in Pakistan.

Key developments

  • Ethics approval for the project has been obtained
  • The study has completed Patient and Public Involvement in the development of the in-depth interview guide and focus group discussion guide
  • Data collection and management is underway
  • A letter of support was acquired from the ministry of health and district health officer, Islamabad, with regards to the participation of lady health workers
  • The study protocol was presented as a poster at the 7th International Conference on Endorsing Health Science Research held at Dow University of Health Sciences in April 2019.

Embedded PhD project

RESPIRE PhD student Hana Mahmood is conducting an embedded project as part of this wider study.

Find out more about Hana's PhD