Perceptions of appropriate treatment among the informal allopathic providers: insights from a qualitative study in two peri-urban areas in Bangladesh

BMC Health Services Research

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[1] 0000 0001 0526 7079, grid.1021.2, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia;0000 0001 0746 8691, grid.52681.38, James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh;0000 0001 2179 088X, grid.1008.9, Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia;0000 0004 0600 7174, grid.414142.6, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;Terre des hommes Foundation, Dhaka, Bangladesh;WaterAid, Dhaka, Bangladesh;mPower Social Enterprises Ltd., Dhaka, Bangladesh;

关键词: Informal providers;    Private sector for health;    Health service delivery;    Appropriate treatment;    Patient safety;   

DOI  :  10.1186/s12913-019-4254-3

来源: publisher

【 摘 要 】

BackgroundHow the informal providers deliver health services are not well understood in Bangladesh. However, their practices are often considered inappropriate and unsafe. This study attempted to fill-in this knowledge gap by exploring their perceptions about diagnosis and appropriate treatment, as well as identifying existing barriers to provide appropriate treatment.MethodsThis exploratory study was conducted in two peri-urban areas of metropolitan Dhaka. Study participants were selected purposively, and an interview guideline was used to collect in-depth data from thirteen providers. Content analysis was applied through data immersion and themes identification, including coding and sub-coding, as well as data display matrix creation to draw conclusion.ResultsThe providers relied mainly on the history and presenting symptoms for diagnosis. Information and guidelines provided by the pharmaceutical representatives were important aids in their diagnosis and treatment decision making. Lack of training, diagnostic tools and medicine, along with consumer demands for certain medicine i.e. antibiotics, were cited as barriers to deliver appropriate care. Effective and supportive supervision, training, patient education, and availability of diagnostics and guidelines in Bangla were considered necessary in overcoming these barriers.ConclusionInformal providers lack the knowledge and skills for delivering appropriate treatment and care. As they provide health services for substantial proportion of the population, it’s crucial that policy makers become cognizant of the fact and take measures to remedy them. This is even more urgent if government’s goal to reach universal health coverage by 2030 is to be achieved.

【 授权许可】

CC BY