Village doctors: a national telephone survey of Bangladesh’s lay medical practitioners
File version
Version of Record (VoR)
Author(s)
Uzzaman, N
Boorman, RJ
Binte Kibria, S
Best, T
Taylor-Robinson, AW
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
Size
File type(s)
Location
Abstract
Background: Bangladesh outperforms its Least Developed Country (LDC) status on a range of health measures including life expectancy. Its frontline medical practitioners, however, are not formally trained medical professionals, but instead lightly-trained ‘village doctors’ able to prescribe modern pharmaceuticals. This current study represents the most complete national survey of these practitioners and their informal ‘clinics’. Methods: The study is based on a national Computer Assisted Telephone Interviewing (CATI) of 1,000 informal practitioners. Participants were sampled from all eight divisions and all 64 districts of Bangladesh, including 682 participants chosen from the purposively recruited Refresher Training program conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), supplemented with 318 additional participants recruited through snowball sampling. Primary and secondary outcome measures: In addition to demographics, village doctors were asked about the characteristics of their ‘clinics’ including their equipment, their training, income and referral practices. Results: Three quarters of the wholly male sample had not completed an undergraduate program, and none of the sample had received any bachelor-level university training in medicine. Medical training was confined to a range of short-course offerings. Village doctor ‘clinics’ are highly dependent on the sale of pharmaceuticals, with few charging a consultation fee. Income was not related to degree of short-course uptake but was related positively to degree of formal education. Finally, practitioners showed a strong tendency to refer patients to the professional medical care system. Conclusions: Bangladesh’s village doctor sector provides an important pathway to professional, trained medical care, and provides some level of care to those who cannot afford or otherwise access the nation’s established healthcare system. However, the degree to which relatively untrained paramedical practitioners are prescribing conventional medicines has concerning health implications.
Journal Title
BMC Health Services Research
Conference Title
Book Title
Edition
Volume
23
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Item Access Status
Note
Access the data
Related item(s)
Subject
Health services and systems
Nursing
Public health
Community pharmacy services
Complementary medicine
Delivery of health care
Developing Countries
Fees, Medical
Persistent link to this record
Citation
Muurlink, O; Uzzaman, N; Boorman, RJ; Binte Kibria, S; Best, T; Taylor-Robinson, AW, Village doctors: a national telephone survey of Bangladesh’s lay medical practitioners, BMC Health Services Research, 2023, 23, pp. 964