To Assess Risk Factors and Comparative Efficacy of Community-based Interventions Related to Childhood Pneumonia on Physiological Parameters among under-5 Children in Selected Urban and Rural Area of Sangli-Miraj-Kupwad

Abstract

Background: Pneumonia remains the leading infectious cause of death among children under five, disproportionately affecting families with limited healthcare access and poor environmental conditions. Community-based interventions offer a scalable strategy for prevention and early management, but comparative urban-rural evidence on their physiological impact remains limited.

Objectives: To assess risk factors of childhood pneumonia and evaluate the comparative efficacy of a community-based intervention package on physiological parameters among under-5 children in urban and rural areas.

Materials and Methods: A two-group pre-test post-test design was used among 140 children with mild-to-moderate pneumonia (70 urban, 70 rural) selected by purposive sampling in Sangli-Miraj-Kupwad. Risk factors and socio-demographic status (graded on the Modified Kuppuswamy Scale) were assessed at baseline. Oxygen saturation, respiratory rate, temperature, and heart rate were recorded before and after a community-based intervention package (nebulization, coughing technique, chest physiotherapy, nutrition support, hydration, and caregiver education). Data were analysed using descriptive statistics, paired and independent 't' tests, one-way ANOVA, chi-square, and multiple regression.

Results: Rural children showed a significantly higher risk-factor burden — indoor air pollution (47.1% vs 12.9%), incomplete immunization (37.1% vs 17.1%), and delayed healthcare access (40.0% vs 11.4%) — than urban children (p<0.05). All four physiological parameters improved significantly from pre- to post-intervention in both areas (paired t = 19.85–26.71, p<0.001). Pre-intervention physiological status was significantly associated with age, socio-economic status, maternal education, and area of residence (p<0.05), but not gender. Indoor air pollution was the strongest independent predictor of severity (β=0.31, p<0.001; R²=0.41).

Conclusion: The community-based intervention package produced statistically significant improvement in physiological parameters among children with pneumonia in both urban and rural settings, with indoor air pollution and healthcare-access barriers identified as priority modifiable risk factors for community-level targeting.