Diagnosis of pneumonia by community health volunteers: experience of BRAC, Bangladesh

Abstract

The study assessed the competency of community health volunteers in diagnosing pneumonia in children through simple clinical signs. Data were collected by a group of research physicians who observed the case management performance of 120 health volunteers in Bangladesh where BRAe has been providing community-based acute respiratory infection (ARI) control programme since mid 1992. About 1,166 children aged 3-60 months were diagnosed at household level using simple signs. Findings revealed that the health volunteers' competency in correctly diagnosing pneumonia and no pneumonia was quite high although they had difficulties in diagnosing severe and very severe pneumonia cases. Among the clinical signs such as coarse breath sounds and chest in-drawing, the correct diagnoses of pneumonia was lower than no pneumonia. Overall agreement rates for most signs were very high. The study concludes that the less educated health volunteers can also be effectively used in diagnosing pneumonia at grassroots level in developing countries.