Determinants and Experiences of Care‐Seeking for Childhood Pneumonia in a Rural Indian Setting: A Mixed‐Methods Study

This study is part of an ongoing implementation research (IR) aimed at improving the effective coverage of childhood pneumonia management in a low-resource setting. A structured engagement with primary caregivers of under-five children, mothers, fathers, family members, community members and local community stakeholders/representatives, for example, local leaders, village heads and so forth, has been integrated at multiple stages to ensure the relevance and applicability of its findings. The current study is part of Phase I (formative research) of the IR, where primary caregivers and family members participated in a needs assessment, providing critical insights into the barriers and facilitators influencing care-seeking for childhood pneumonia in a rural low-to-middle socio-economic setting. Their inputs have informed the refinement of study tools and the development of mitigation strategies for the logic and implementation model. As the research progresses into Phase II (model development and implementation), the community continues to play an integral role in providing feedback on the feasibility and appropriateness of proposed strategies. This ongoing feedback loop assesses how effectively these strategies strengthen linkages between the healthcare system and the community, foster an active local needs assessment mechanism among healthcare providers and enhance demand generation for appropriate pneumonia care-seeking. These iterative refinements ensure that the implementation strategies remain responsive to the evolving needs of the community. In the forthcoming Phase III, which will focus on scaling up the finalised implementation model, strategies will be adapted to further improve care-seeking for under-five children. Continuous engagement with caregivers and local community representatives, including Panchayati Raj Institution (PRI) members, will be central to refining these strategies. Additionally, during the dissemination phase, key findings will be shared with caregivers, community members and PRI representatives, facilitating discussions on study implications and informing future policy and programmatic decisions. Their ongoing involvement will help contextualise findings and enhance the long-term sustainability of strategies aimed at improving pneumonia care-seeking behaviours and effective management in rural India.