Objective Delays in seeking medical attention for childhood pneumonia may lead to increased morbidity and mortality. This study aimed at identifying the drivers of delayed seeking of treatment for severe childhood pneumonia in rural Bangladesh. Methods We conducted a formative study from June to September 2015 in one northern district of Bangladesh. In-depth interviews were conducted with 20 rural mothers of children under 5 years with moderate or severe pneumonia. We analysed the data thematically. Results We found that mothers often failed to assess severity of pneumonia accurately due to lack of knowledge or misperception about symptoms of pneumonia. Several factors delayed timely steps that could lead to initiation of appropriate treatment. They included time lost in consultation with non-formal practitioners, social norms that required mothers to seek permission from male household heads (eg, husbands) before they could seek healthcare for their children, avoiding community-based public health centres due to their irregular schedules, lack of medical supplies, shortage of hospital beds and long distance of secondary or tertiary hospitals from households. Financial hardships and inability to identify a substitute caregiver for other children at home while the mother accompanied the sick child in hospital were other factors. Conclusions This study identified key social, economic and infrastructural factors that lead to delayed treatment for childhood pneumonia in the study district in rural Bangladesh. Interventions that inform mothers and empower women in the decision to seek healthcare, as well as improvement of infrastructure at the facility level could lead to improved behaviour in seeking and getting treatment of childhood pneumonia in rural Bangladesh. Data are available on reasonable request. Access to field notes and anonymized printed transcripts of the interviews will be restricted to individuals granted permission by the corresponding author, for the purposes of future research.

中文翻译：

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在孟加拉国农村寻求及时治疗严重儿童肺炎的障碍

目的 延误儿童肺炎就医可能导致发病率和死亡率增加。本研究旨在确定孟加拉国农村严重儿童肺炎延迟寻求治疗的驱动因素。方法 我们于 2015 年 6 月至 2015 年 9 月在孟加拉国北部的一个地区进行了一项形成性研究。对20名5岁以下中重度肺炎患儿的农村母亲进行了深入访谈。我们对数据进行了专题分析。结果 我们发现，由于缺乏对肺炎症状的知识或误解，母亲经常无法准确评估肺炎的严重程度。有几个因素延迟了可能导致开始适当治疗的及时步骤。其中包括与非正规从业者协商所浪费的时间，社会规范要求母亲在为孩子寻求医疗保健之前必须征得男性户主（例如丈夫）的许可，避免社区公共卫生中心由于其不定期的日程安排、缺乏医疗用品、医院床位短缺和长期二级或三级医院与家庭的距离。经济困难和无法在母亲陪同生病的孩子住院时在家中为其他孩子找到替代照顾者是其他因素。结论 本研究确定了导致孟加拉国农村研究区儿童肺炎延迟治疗的关键社会、经济和基础设施因素。告知母亲并赋予妇女寻求医疗保健决定权的干预措施，以及设施一级基础设施的改善可能会导致孟加拉国农村儿童肺炎寻求和治疗行为的改善。可根据合理要求提供数据。出于未来研究的目的，访问现场记录和匿名印刷的采访记录将仅限于获得通讯作者许可的个人。