Co-designing and optimising a primary care implementation model for childhood pneumonia management in a low-resource setting using principles of implementation research
Interventional trial demonstrates improved care-seeking and guideline adherence for childhood pneumonia, indicating viable implementation models for low-resource primary care.
Key Points
To systematically develop and iteratively optimize a primary care implementation model for childhood pneumonia management in a low-resource setting using implementation research principles.
Conducted a mixed-methods iterative Phase II study (September 2023–May 2024; CTRI/2021/03/031622) in Palwal district, Haryana, India, across a learning cluster of approximately 50,000 inhabitants.
Applied the CFIR-ERIC Barrier Busting Tool and participatory co-design workshops with government and community stakeholders to construct an Implementation Research Logic Model.
Identified 33 tailored implementation strategies targeting barriers across CFIR inner, outer, individual, process, and innovation domains.
Iterative refinement across three models increased appropriate primary care-seeking from 0.8% at baseline to 76.0% (193/254 cases) and appropriate diagnosis from 0% to 92.7% (179/193 cases).
Fidelity to guideline-based clinical management reached 86.0% (154/179 cases) by the end of Phase II.