Pakistan: Children With Pneumonia Fare Better With Home Treatment, Study Finds

Letting “lady health workers” in rural northern Pakistan treat children with severe pneumonia in their homes worked better than the established practice of telling parents to take them to a hospital, a new study has found.

The study, published in The Lancet this month, followed 1,857 children who were treated at home with oral amoxicillin for five days and 1,354 children in a control group who were given standard care: one dose of oral cotrimoxazole and instructions to go to the nearest hospital or clinic.
The home-treated group had only a 9 percent treatment-failure rate, while the control group children failed to improve 18 percent of the time.
Some parents could not afford to take their children to hospitals, which were often understaffed.
Researchers from Save the Children, the World Health Organization and Boston University did the study, which was financed by the United States Agency for International Development. Pneumonia is a major killer of infants and toddlers.
Pakistan’s network of 90,000 “lady health workers” was founded in 1994 by Benazir Bhutto, then the prime minister.
“It’s one of the best community-based health systems in the world,” said Dr. Donald Thea, a Boston University researcher who was one of the authors.
A Lancet editorial cautioned that not all local health workers are as well trained and supervised as Pakistan’s and that since northern Pakistan has a low AIDS rate, it would be wrong to assume that every country would do as well with such a system.