Document Detail


What do they do? Interactions between village doctors and medical representatives in Chakaria, Bangladesh.
MedLine Citation:
PMID:  25406239     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Informally trained village doctors supply the majority of healthcare services to the rural poor in many developing countries. This study describes the demographic and socio-economic differences between medical representatives (MRs) and village doctors in rural Bangladesh, and explores the nature of their interactions.
METHODS: This study was conducted in Chakaria, a rural sub-district of Bangladesh. Focus group discussions and in-depth interviews were conducted, along with a quantitative survey to understand practice perceptions. Data analysis was performed using grounded theory and bivariate statistical tests.
RESULTS: We surveyed 43 MRs and 83 village doctors through 22 focus group discussions and 33 in-depth interviews. MRs have a higher average per capita monthly expenditure compared to village doctors. MRs are better educated with 98% having bachelor's degrees whereas 84% of village doctors have twelfth grade education or less (p<0.001). MRs are the principal information source about new medications for the village doctors. Furthermore, incentives offered by MRs, and credit availability influence the prescription practices of village doctors.
CONCLUSIONS: MRs being the key player in providing information about drugs to village doctors might influence their prescription practices. Improvements in the quality of healthcare delivered to the rural poor in informal provider-based health markets require stricter regulations and educational initiatives for providers and MRs.
Authors:
M Hafizur Rahman; Smisha Agarwal; Susan Tuddenham; Heather Peto; Mohammad Iqbal; Abbas Bhuiya; David H Peters
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-17
Journal Detail:
Title:  International health     Volume:  -     ISSN:  1876-3405     ISO Abbreviation:  Int Health     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-19     Completed Date:  -     Revised Date:  2014-11-20    
Medline Journal Info:
Nlm Unique ID:  101517095     Medline TA:  Int Health     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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