{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T01:53:27Z","timestamp":1773280407625,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,1,18]],"date-time":"2020-01-18T00:00:00Z","timestamp":1579305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In India, frontline workers (FLWs) \u2013 public accredited social health activists (ASHAs) and private rural medical providers (RMPs) \u2013 are important for early detection and treatment of childhood diarrhoea and pneumonia. This cross\u2010sectional study aims to measure knowledge and skills, and the gap between the two (\u2018know\u2010can\u2019 gap), regarding assessment of childhood diarrhoea with dehydration and pneumonia among FLWs, and to explore factors associated with them.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We surveyed 473 ASHAs and 447 RMPs in six districts of Uttar Pradesh. We assessed knowledge and skills using face\u2010to\u2010face interviews and video vignettes, respectively, about key signs of both conditions. The \u2018know\u2010can\u2019 gap corresponds to absent skills among FLWs with correct knowledge. We used logistic regression to identify the correlates of knowledge and skills.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>FLWs\u2019 correct knowledge ranged from 23% to 48% for dehydration signs and 27% to 37% for pneumonia signs. Their skills ranged from 3% to 42% for dehydration and 3% to 18% for pneumonia. There was a significant \u2018know\u2010can\u2019 gap in all the signs, except \u2018sunken eyes\u2019. Training and supervisory support was associated with better knowledge and skills for diarrhoea with dehydration, but only better knowledge for pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>FLWs are crucial to the Indian health system, and high\u2010quality FLW services are necessary for continued progress against under\u2010five deaths. The gap between FLWs\u2019 knowledge and skills warrants immediate attention. In particular, our results suggest that knowledge\u2010focused trainings are insufficient for FLWs to convert knowledge into appropriate assessment skills.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13365","type":"journal-article","created":{"date-parts":[[2019,12,21]],"date-time":"2019-12-21T12:55:15Z","timestamp":1576932915000},"page":"454-466","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["\u2018<i>Know\u2010Can<\/i>\u2019 gap: gap between knowledge and skills related to childhood diarrhoea and pneumonia among frontline workers in rural Uttar Pradesh, India"],"prefix":"10.1111","volume":"25","author":[{"given":"Lopamudra","family":"Ray Saraswati","sequence":"first","affiliation":[{"name":"RTI International India New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Baker","sequence":"additional","affiliation":[{"name":"RTI International Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashutosh","family":"Mishra","sequence":"additional","affiliation":[{"name":"RTI International India New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prince","family":"Bhandari","sequence":"additional","affiliation":[{"name":"RTI International India New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Animesh","family":"Rai","sequence":"additional","affiliation":[{"name":"RTI International India New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Punit","family":"Mishra","sequence":"additional","affiliation":[{"name":"RTI International India New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambrish","family":"Chandan","sequence":"additional","affiliation":[{"name":"RTI International India New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryanne","family":"Crockett","sequence":"additional","affiliation":[{"name":"University of Manitoba Winnipeg Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorine","family":"Pelly","sequence":"additional","affiliation":[{"name":"University of Manitoba Winnipeg Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Anthony","sequence":"additional","affiliation":[{"name":"University of Manitoba Winnipeg Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mrunal","family":"Shetye","sequence":"additional","affiliation":[{"name":"Bill &amp; Melinda Gates Foundation New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karol","family":"Krotki","sequence":"additional","affiliation":[{"name":"RTI International Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Kraemer","sequence":"additional","affiliation":[{"name":"Georgetown University Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,18]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Family Health Survey (MCH and Family Planning), India 1992\u201393","author":"IIPS","year":"1995"},{"key":"e_1_2_6_3_1","volume-title":"National Family Health Survey (NFHS\u20104), 2015\u201016: India","author":"IIPS","year":"2017"},{"key":"e_1_2_6_4_1","unstructured":"UNICEF.Committing to Child Survival: A Promise Renewed. Progress Report 2015. UNICEF;2015."},{"key":"e_1_2_6_5_1","unstructured":"IVAC.Pneumonia and Diarrhea Progress Report 2015: Sustainable Progress in the Post\u20102015 Era. International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health;2015."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60560-1"},{"key":"e_1_2_6_7_1","unstructured":"Child Mortality Estimates \u2013 Country\u2010specific under\u2010five mortality rate [Internet]. United Nations Inter\u2010agency Group for Child Mortality Estimation (UN IGME) 2017. (Available from:http:\/\/data.unicef.org)"},{"key":"e_1_2_6_8_1","unstructured":"UN.Sustainable Development Goals: 17 goals to transform our world: United Nations;2015(Available from:http:\/\/www.un.org\/sustainabledevelopment\/sustainable-development-goals\/)."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10728-007-0060-x"},{"key":"e_1_2_6_10_1","unstructured":"IIPS.National Family Health Survey (NFHS\u20103) 2005\u201306 India: Key Findings. International Institute for Population Sciences (IIPS) and Macro International;2007."},{"key":"e_1_2_6_11_1","volume-title":"ASHA: which way forward\u2026? Executive Summary \u2013 Evaluation of ASHA Program","author":"NHSRC","year":"2011"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2014.3445"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.05.020410"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1257\/jep.22.2.93"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdeveco.2006.05.004"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2011.1356"},{"key":"e_1_2_6_17_1","first-page":"343","volume-title":"Practising Health for All","author":"Bose A","year":"1983"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-6-92"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0130845"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-4-200502150-00008"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.11.028"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czx153"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-6787.2012.00263.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-6-92"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-016-0120-5"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0074882"},{"key":"e_1_2_6_27_1","article-title":"Policy makers perceptions regarding the performance of the LHW program: Is there a knowdo gap? Findings from the NIGRAAN project","volume":"5","author":"Rabbani F","year":"2015","journal-title":"Pakistan Journal of Public Health"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12960-016-0164-1"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12076"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-54"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.3368\/jhr.XLII.3.682"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2005.03.043"},{"key":"e_1_2_6_33_1","unstructured":"WHO.The Treatment of Diarrhoea: A Manual for Physicians and Other Senior Health Workers \u2013 4th rev.Department of Child and Adolescent Health and Development World Health Organization:Geneva;2005. (Available from:http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/43209\/9241593180.pdf?sequence=1)."},{"key":"e_1_2_6_34_1","unstructured":"WHO.Pocket book of hospital care for children: Guidelines for the management of common childhood illnesses(2nd edn).World Health Organization;2013. (Available from:http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/81170\/9789241548373_eng.pdf?sequence=1)."},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdeveco.2004.11.004"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdeveco.2009.11.001"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1564"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmq106"},{"key":"e_1_2_6_39_1","unstructured":"IntraHealth.Mobile Application Reinforces Frontline Health Workers\u2019 Knowledge Confidence and Credibility: IntraHealth International;2012. (Available from:https:\/\/www.intrahealth.org\/features\/mobile-application-reinforces-frontline-health-workers%E2%80%99-knowledge-confidence-and) [19 June 2012]."}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftmi.13365","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13365","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.13365","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T22:38:32Z","timestamp":1694039912000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.13365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,18]]},"references-count":38,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1111\/tmi.13365"],"URL":"https:\/\/doi.org\/10.1111\/tmi.13365","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,18]]},"assertion":[{"value":"2020-01-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}