NIHR Global Health Research Unit on Respiratory Health (RESPIRE)

Understanding the reasons for delay in seeking care for pneumonia

This project is based at Neoventive Solutions 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:  Neoventive Solutions
  • Start date:  December 2018
  • End date:  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

  • Project final report submitted.
  • A manuscript focusing on design of the intervention has been submitted to the editor of the International Journal of Environmental and Public Health.
  • The output of the project was discussed in a meeting with additional district coordinator and the district health officer in two separate meetings.
  • Stall exhibited at the International Conference on Early Childhood Development to promote RESPIRE projects and to share findings of the projects with the wider community. Attended by officials from the Pakistan MoH, Ministry of Federal Education, NGOs and various other organisations.
  • Educational materials on the identification, prevention and management of pneumonia in under-five children were developed in the Urdu language.
  • Conducted 3 seminars for medical students on RESPIRE research findings and raising awareness about prevention of childhood pneumonia.
  • Brochures were distributed to the primary school pupils and banners displayed outside the public schools of Federal capital Islamabad to create awareness among the caregivers.

Project data

Download the project Data Management Plan

View the project metadata on the Health Data Research Innovation Gateway

View the Focus Group Discussion metadata on Edinburgh DataShare

View the In-Depth Interview metadata on Edinburgh DataShare

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