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

Abstract：

BACKGROUND:How 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. METHODS:This 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. RESULTS:The 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. CONCLUSION:Informal 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.

journal_name

BMC Health Serv Res

journal_title

BMC health services research

authors

Sizear MMI,Nababan HY,Siddique MKB,Islam S,Paul S,Paul AK,Ahmed SM

doi

10.1186/s12913-019-4254-3

subject

Has Abstract

pub_date

2019-06-26 00:00:00

pages

424

issue

issn

1472-6963

pii

10.1186/s12913-019-4254-3

journal_volume

pub_type

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