Training can improve unlicensed health care providers: Study

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Modest levels of medical training can improve the quality of health care furnished by unlicensed health care practitioners, says a recent study conducted in West Bengal.

The study, in the form of a novel field experiment shows that informal care providers are more likely to handle cases correctly and compile basic checklists of patient information after undergoing about 150 hours of training over a period of months.

“They do seem to be learning, and they are using this knowledge,” said Abhijit Banerjee, the Ford International Professor of Economics at MIT and co-author of the study, in a media release.

The state government sponsored study, published in October in the journal Science, was conducted with the cooperation of 304 informal health care providers in Bengal. The 150 hours of training the participants received was divided into 72 sessions over a nine-month period.

In rural India, self-declared “doctors” and health care providers without formal medical training are sought for up to 75 per cent of primary care visits, the statement said.

The frequent use of such informal providers, despite legal prohibitions on their practices, in part reflects the absence of trained medical professionals in rural locations.

The experiment analysed whether unlicensed health care providers could act adequately when faced with information pertaining to three types of illnesses — chest pain, breathing problems, and diarrhea — that require different types of responses.

“It evaluates your general skill as a health care provider,” Banerjee said.

Banerjee added that the low-cost experiment is now being scaled up by Bengal, to see if this approach can improve care for segments of the population that do not regularly access formal medical providers.

About 54 per cent of primary-care medical visits in West Bengal occur in these informal settings.

The authors of the study are Banerjee, Jishnu Das of the World Bank, Abhijit Chowdhury of Institute of Post Graduate Medical Education and Research at SSKM Hospitals in Kolkata, and Reshmaan Hussam, a post-doctorate at Yale University.

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