ArticleBMC health services research2023
Beyond the regulatory radar: knowledge and practices of rural medical practitioners in Bangladesh.
Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed.
- A Codesigned Approach to Develop Tailored Antimicrobial Stewardship Strategies in Bangladesh: A Social-Ecological Systems Framework Analysis.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Antibiotic dispensing practices and determinants among informal healthcare providers in low- and middle-income countries: a mixed-methods scoping review.BMJ global health · 2026Article
- Prescribing patterns of antibiotics according to the WHO access, watch, and reserve (AWaRe) classification in the pediatric outpatient department: A prospective study.Pakistan journal of medical sciences · 2025Article
- Physicians' Perspectives Regarding Informal Health Practitioners in Bangladesh.The American journal of tropical medicine and hygiene · 2025Article
- Relationship Among Village Doctor Training Level, Proximity to a Main Road, and Availability to Administer Intravenous Fluids for Diarrheal Illness.Open forum infectious diseases · 2025Article
- Incidence of prevalent diseases in infants in Primary Health Care: a cohort study.Revista da Escola de Enfermagem da U S P · 2025Article
- Potential for an Electronic Clinical Decision Support Tool to Support Appropriate Antibiotic Use for Pediatric Diarrhea Among Village Doctors in Bangladesh.Journal of the Pediatric Infectious Diseases Society · 2024Article
- Walking a tightrope: perspectives of non-degree allopathic providers (NDAPs) on providing diabetes and hypertension care in urban informal settlements of Mumbai Metropolitan Region.BMC health services research · 2024Article
- Leveraging the social networks of informal healthcare providers for universal health coverage: insights from the Indian Sundarbans.Health policy and planning · 2024Article
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12 authors.
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Abstract
backgroundInformal and unregulated rural medical practitioners (RMPs) provide healthcare services to about two-thirds of people in Bangladesh, although their service is assumed to be substandard by qualified providers. As the RMPs are embedded in the local community and provide low-cost services, their practice pattern demands investigation to identify the shortfalls and design effective strategies to ameliorate the service.
methodsWe conducted a cross-sectional study in 2015-16 using a convenient sample from all 64 districts of Bangladesh. Personnel practising modern medicine, without any recognized training, or with recognized training but practising outside their defined roles, and without any regulatory oversight were invited to take part in the study. Appropriateness of the diagnosis and the rationality of antibiotic and other drug use were measured as per the Integrated Management of Childhood Illness guideline.
resultsWe invited 1004 RMPs, of whom 877 consented. Among them, 656 (74.8%) RMPs owned a drugstore, 706 (78.2%) had formal education below higher secondary level, and 844 (96.2%) had informal training outside regulatory oversight during or after induction into the profession. The most common diseases encountered by them were common cold, pneumonia, and diarrhoea. 583 (66.5%) RMPs did not dispense any antibiotic for common cold symptoms. 59 (6.7%) and 64 (7.3%) of them could identify all main symptoms of pneumonia and diarrhoea, respectively. In pneumonia, 28 (3.2%) RMPs dispensed amoxicillin as first-line treatment, 819 (93.4%) dispensed different antibiotics including ceftriaxone, 721 (82.2%) dispensed salbutamol, and 278 (31.7%) dispensed steroid. In diarrhoea, 824 (94.0%) RMPs dispensed antibiotic, 937 (95.4%) dispensed ORS, 709 (80.8%) dispensed antiprotozoal, and 15 (1.7%) refrained from dispensing antibiotic and antiprotozoal together.
conclusionsInappropriate diagnoses, irrational use of antibiotics and other drugs, and polypharmacy were observed in the practising pattern of RMPs. The government and other stakeholders should acknowledge them as crucial partners in the healthcare sector and consider ways to incorporate them into curative and preventive care.
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