75pc quacks prescribe 'wrong drugs'
Reveals study
The acute shortage of qualified doctors in rural Bangladesh has given quacks the opportunity to dominate the health of rural people, says an ICDDR, B study.
The study reveals that almost nine out of 10 people resort to unqualified doctors instead of seeing medical graduates. The quacks, known as 'village doctors', are popular with patients from all socio-economic groups, it says.
Only a very few village doctors, who practice allopathy, have proper knowledge on common rural diseases like child pneumonia, diarrhoea, cold, and fever, says the study.
But in practice only 18 per cent prescribe appropriate drugs, while 75 percent suggest inappropriate medicines, and seven per cent recommend harmful remedies.
Social and Behavioral Sciences Division of International Center for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), has been conducting the four-year action-research about to end soon.
Low treatment cost, easy accessibility, and some other conveniences have made it possible for quacks to control rural people's health over decades.
The number of informal healthcare providers, especially the village doctors, has increased sharply by four to five per cent a year during the last decade -- it shows the increasing demand for quacks.
The village doctors, who are now major source of healthcare providers for rural folks, often resort to inappropriate and even harmful practices.
But most villagers believe that they have been receiving quality healthcare from the quacks who are available round-the-clock, offer low cost and better attention, prescribe small number of drugs within patients' purchasing power, and seldom ask for diagnostic tests.
These village doctors had embarked on the profession by attending short courses or training, or being a trainee in drug store or an assistant in a doctor's chamber, or by inheriting the livelihood from family.
Principal Investigator Dr Abbas Bhuiya of the study said the action-research has unearthed a number of issues for policy interventions to improve the rural health system within available resources.
He says the village doctors occupy much of the rural areas because the country faces acute shortage of qualified health professionals, especially MBBS doctors.
A nationwide survey in 2007 estimated that the country has a shortage of 60,000 qualified physicians, 280,000 nurses, and 483,000 health technologists.
With some 40,000 MBBS doctors, and slow manpower development in health sector, it is unlikely that the nation would overcome the huge shortage of health workforce in near future, concludes the survey.
"And this is the gap which village doctors are plugging," observes Dr Mohammad Iqbal, one of the key investigators of the ICDDR, B study being done over 6,000 people.
Dr Iqbal says the gap-filling is taking place as the informal health sector develops in an unhealthy manner with inadequate actions to stop it.
The qualified MBBS doctors can attract a few patients mainly because of high treatment costs, which include consultation fees, medicine price, and diagnostic tests. The MBSS doctors at local levels find themselves hardly relaxed, as one doctor has to attend a lot of patients at a time, it observes.
Experiences from Nepal, Thailand, Laos and Vietnam show that better health services could be ensured for rural folks by improving the knowledge and practice of these semi or unqualified quacks.
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