India trains informal healthcare providers for better healthcare quality
In rural India, patients seek medical care from self-declared “doctors” and healthcare providers with no formal medical training in up to 75% of primary care visits, according to a new study. But researchers in India and the US found that training informal healthcare providers in India improved the quality of healthcare they offered to the patients in rural regions.
Despite the legal prohibitions on the practices of the informal medical care providers, patients still frequently seek care from these informal providers. This reflects, in part, the absence of trained medical professionals in rural locations such as the Indian states of Rajasthan, Madhya Pradesh, and West Bengal.
According to the study’s corresponding author Dr. A.V. Banerjee from Massachusetts Institute of Technology in Cambridge, Massachusetts in the US, their study suggests “that there is a ‘low hanging fruit’ as the training is cheap and it does make these practitioners better”.
More than 300 informal healthcare providers in West Bengal were involved in the randomized, controlled trial that was done. Some of whom were trained in 72 low-cost sessions over nine months
Training programs focused on multiple diseases and covered a diverse range of topics, from human anatomy to clinical practice.
But the researchers found that these programs increased correct case management for ailments like angina, diarrhea, and asthma by 7.9%, compared to the control group of untrained providers.
Although the training programs had a significant impact on the quality of healthcare provided to the patients, it still did not have a significant effect on drug-prescribing behavior, which includes the increasingly significant problem of over-prescribing antibiotics.
According to Banerjee, this is probably because patients in India want drugs, and think they have been ‘cheated’ if they don’t get any. He also noted that the providers make money from sales and distribution of the drugs.
In the future, the research team, from the Center for Policy Research, New Delhi, and Institute of Post Graduate Medical Education and Research, West Bengal, intends to find out if they can influence the use of unnecessary drugs by making the patients more aware of the damage they do, according to Banerjee.
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