Feasibility of engaging 'Village Doctors' in the Community-based Integrated Management of Childhood Illness (C-IMCI): experience from rural Bangladesh
| Autor: | Jennifer Bryce, Aliki Christou, Dm Emdadul Hoque, Qazi Sadeq-ur Rahman, Sk Masum Billah, Muntasirur Rahman, Ngatho Samuel Mugo, Tazeen Tahsina, Twaha M. Haque, Ashraf Siddik, Rasheda Khan, Enayet K. Chowdhury, Khadija Begum, Robert E. Black, Shams El Arifeen |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty education Child Health Services Mothers 03 medical and health sciences 0302 clinical medicine Intervention (counseling) Health care Medicine Humans 030212 general & internal medicine Medical prescription Qualitative Research Aged Integrated Management of Childhood Illness Community Health Workers Bangladesh business.industry Delivery of Health Care Integrated 030503 health policy & services Health Policy Public Health Environmental and Occupational Health Infant Newborn Infant Articles Middle Aged Patient Acceptance of Health Care medicine.disease Test (assessment) Pneumonia Incentive Family medicine Child Preschool Feasibility Studies Female Clinical Competence Rural Health Services 0305 other medical science business Qualitative research |
| Zdroj: | Journal of Global Health |
| ISSN: | 2047-2986 2047-2978 |
| Popis: | Results: Village doctors' knowledge on the assessment and management of childhood illnesses improved significantly after training; knowledge of danger signs of pneumonia and severe pneumonia increased from 39% to 78% (P < 0.0001) and from 17% to 47% (P < 0.0001) respectively. Knowledge on the correct management of severe pneumonia increased from 62% to 84% (P < 0.0001), and diarrhoea management improved from 65% to 82% (P = 0.0005). Village doctors retained this knowledge over three years except for home management of pneumonia. No significant differences were observed in prescribing practices for diarrhoea and pneumonia management between trained and untrained village doctors. Village doctors were accessible to communities; 76% had cell phones; almost all attended home calls, and did not charge consultation fees. Nearly all (91%) received incentives from pharmaceutical representatives.Conclusions: Village doctors have the capacity to learn and retain knowledge on the appropriate management of under-five illnesses. Training alone did not improve inappropriate antibiotic prescription practices. Intensive monitoring and efforts to target key actors including pharmaceutical companies, which influence village doctors dispensing practices, and implementation of mechanisms to track and regulate these providers are necessary for future engagement in management of under-five childhood illnesses.Background: Informal health care providers particularly "village doctors" are the first point of care for under-five childhood illnesses in rural Bangladesh. We engaged village doctors as part of the Multi-Country Evaluation (MCE) of Integrated Management of Childhood Illness (IMCI) and assessed their management of sick under-five children before and after a modified IMCI training, supplemented with ongoing monitoring and supportive supervision.Methods: In 2003-2004, 144 village doctors across 131 IMCI intervention villages in Matlab Bangladesh participated in a two-day IMCI training; 135 of which completed pre- and post-training evaluation tests. In 2007, 38 IMCI-trained village doctors completed an end-of-project knowledge retention test. Village doctor prescription practices for sick under-five children were examined through household surveys, and routine monitoring visits. In-depth interviews were done with mothers seeking care from village doctors. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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