Knowledge and practice of unqualified and semi-qualified allopathic providers in rural Bangladesh: implications for the HRH problem.

Objectives: To explore current knowledge and practice of the unqualified/semi-qualified allopathic providers in the informal sector in rural Bangladesh to develop informed and need-based intervention for them.

Methods: A cross-sectional descriptive survey was conducted in three conveniently selected sub-districts in the northern part of Bangladesh where a targeted poverty alleviation programme for the ultra poor was initiated in 2002. Semi-structured, pre-tested questionnaires were used to elicit information on socio-demographic, training and professional characteristics, and knowledge and practices on some common illnesses and conditions. Two-way and three-way cross-tabulations were done to compare and contrast the different groups, using SPSS PC+ ver.12.

Results: The different groups of providers were found to possess superficial knowledge on the conditions they commonly provide services for. Differences were noted between the unqualified and semi-qualified providers with respect to knowledge and practice on common illnesses and conditions, and especially rational use of drugs and management of pregnancy and its complications.

Conclusion: Given the shortage of qualified healthcare professionals in rural Bangladesh, the importance of these informal providers should be recognized by the public sector, and their capacity developed in a planned way to improve their effectiveness and reduce irrational use of drugs.