Delays in pathways to care in children with congenital heart disease presenting to a tertiary care hospital in Delhi.

This study aims to assess delays in the diagnosis of congenital heart disease in children presenting to a tertiary care hospital in Delhi. Congenital heart disease is one of the most common birth defects and early diagnosis is critical for reducing morbidity and mortality. In low and middle income settings, delays in diagnosis are common and often linked to late recognition of symptoms, gaps in screening, limited access to specialist care, and barriers within the health system. Understanding these delays is important for designing effective interventions and improving timely access to treatment.

This is a facility based cross sectional study conducted in the Pediatrics Department of Lok Nayak Hospital and the Cardiology Department of GB Pant Hospital. Children aged one month to five years diagnosed with congenital heart disease will be included using a consecutive sampling approach. A minimum sample of one hundred children will be enrolled. Data will be collected through a pretested semi structured questionnaire administered to caregivers. Information will be gathered on sociodemographic characteristics, antenatal and birth history, onset of symptoms, caregiver response, health seeking behavior, dates related to first symptom, first presentation, and confirmed diagnosis, as well as barriers to accessing care and awareness of congenital heart disease.

The primary outcome is the proportion of children experiencing delayed diagnosis. Secondary outcomes include estimating the duration of the patient interval and the diagnostic interval, along with identifying factors associated with delays. Data will be analyzed using descriptive and inferential statistics. Written informed consent will be obtained from all caregivers and ethical approval will be secured from the Institutional Ethics Committee.