Practicing Correct Management of Pneumonia in Mewat, Haryana
On February 24, 2019, Jafreen, visited Health and Wellness Center (HWC) in Dhulawat village in Mewat district of Haryana with her 18 months old daughter, Nargis. Nargis was suffering from cold and cough for past 3 days. At the HWC, Child Health Officer (CHO), Ms. Mumtaz has been treating patients at this centre after being posted in July 2019.
Ms. Mumtaj examined Nargis, and observed severe cold with wet cough but no signs of fever. Suspecting it to be pneumonia, Ms. Mumtaj used the multi modal pulse oximeter Rad G device to check oxygen saturation in the blood (SPO2) and Respiratory Count. The respiration rate was higher than normal, which made her suspicion of pneumonia correct. Mumtaj prescribed a dosage of antibiotic Amoxicillin syrup as per the WHO IMNCI chart. She explained Jafreen the precautionary measures to be taken and also informed her about the signs of danger. Two days later Jafreen was back with her daughter. But this time she had a smile of relief on her face. Nargis was getting better.
Jafreen came to know of the HWC and the better diagnosis, made possible by Rad G from her neighbor. She says, “Earlier we used to go to the local doctor in the village who gave medicines and injections and ended up spending Rs 200-300 for such illness. I am happy to receive correct diagnosis of my daughter and got medicines free of cost.”
Ms Mumtaj, CHO Dhulawat, Mewat, says, “Whenever a parent brings their child to the HWC, with complaint of cold and cough, I first check with the multi modal pulse oximeter to exclude pneumonia. It has helped in getting nearly accurate data on the pneumonia. The three days IMCNI training by USAID Vriddhi project is helping a lot for correct management of cases in HWC. The multi modal device Rad G provided is very useful for correct diagnosis of pneumonia in children. The change in nature of treatment (for example, instead of heavy dosage of medication, cost effective and home remedy medications) and diagnosis with this innovation, has helped people gain trust in us. Earlier the treatment and diagnosis with manual count of respiration by checking chest in drawing, would be time consuming and other methods of treating would be expensive. Also, at times we would miss out on certain symptoms in pneumonia cases, whereas now, no case remain untreated. With this device usage, as no other doctor or clinic have access to it, I have become popular in the area.”
Further, CHO Mumtaj shares that under-five mortality in Haryana is 35/1000 live births, among which pneumonia remains one of the major causes of death among children. In HWC Dhulawat, from June 2019 – Jan 2020, 303 under five children with cough were screened for pneumonia. With the help of the device, she was able to detect and referred 3 cases of severe pneumonia and treated 83 children with Pneumonia. There has been appropriate use of antibiotics where in all cases of no pneumonia were managed without antibiotics through supportive homecare.
The multi modal pulse oximeter device called RAD G, designed by Masimo Health is a novel device which records and displays SPO2 and respiratory count of patient, helps in screening pneumonia. The pulse oximeter was introduced in the month of June 2019 by USAID Vriddhi project/IPE Global under Ministry of Health and Family Welfare (MoHFW), Government of India (GOI). The device has a small cap which is placed on any finger of child’s hand or feet. It takes about a minute to record the readings.
Use of the device Pulse Oximeter RAD G is feasible, acceptable, and has shown good impact, and cost-effectiveness for effective pneumonia management. Under government’s package of IMNCI training, this multi modal device was introduced at selected HWCs across the states of Chhattisgarh, Haryana, Himachal Pradesh, Jharkhand, Odisha, Punjab and Uttarakhand, aiming to reduce under-five mortality rate in India.