Abstract:
INTRODUCTION:In many parts of the developing world, access to physician consultation and neurologic expertise is limited or nonexistent. We conducted a survey among non-physician, primary healthcare workers (PHCWs) to determine the neurological needs and services in rural Zambia. METHODS:Semi-structured written questionnaire utilizing fill-in-the-blank, multiple-choice likert-scaled questions, and open-ended questions. RESULTS:Seizures were reported as the most common neurologic disorder by 66% of the PHCWs. Only 1/3 of PHCWs reported feeling adequately trained to care for seizures and seizure disorders. PHCWs reported even less expertise for other neurologic conditions. Over 40% of PHCWs surveyed work in primary care clinics without a physician available for consultation. Their patients must travel a median of 50 km to access a physician and geographic barriers are a frequent problem. In addition to difficulty physically accessing care, PHCWs reported that financial barriers to physician referral are substantial. Expenses cited include additional user fees for physician-level care, transportation costs, and the cost of maintaining the patient and/or family at a site distant from the home village. Traditional beliefs, social stigma, and discriminatory healthcare policies associated with neurologic conditions were also noted to deter and defer care and care seeking. CONCLUSIONS:PHCWs lack sufficient training and experience to care for the neurologic disorders in their patient populations, although such disorders are relatively common. Geographic, financial and cultural barriers substantially limit physician referrals. To assure at least a minimal quality of care for people with nervous system disorders in Zambia, PHCWs' neurologic education must be increased and barriers to physician referral decreased.
journal_name
J Neurol Scijournal_title
Journal of the neurological sciencesauthors
Birbeck GL,Munsat Tdoi
10.1016/s0022-510x(02)00132-6subject
Has Abstractpub_date
2002-08-15 00:00:00pages
75-8issue
1-2eissn
0022-510Xissn
1878-5883pii
S0022510X02001326journal_volume
200pub_type
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of the neurological sciences
pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2016-08-15 00:00:00
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journal_title:Journal of the neurological sciences
pub_type: 杂志文章
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更新日期:2016-04-15 00:00:00
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pub_type: 杂志文章
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