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孟加拉国的“乡村医生”是祸是福?

Are 'Village Doctors' in Bangladesh a curse or a blessing?

机构信息

Social and Behavioural Sciences Unit, Public Health Sciences Division, ICDDR, B GPO Box 128, Dhaka 1000 Bangladesh.

出版信息

BMC Int Health Hum Rights. 2010 Jul 6;10:18. doi: 10.1186/1472-698X-10-18.

Abstract

BACKGROUND

Bangladesh is one of the health workforce crisis countries in the world. In the face of an acute shortage of trained professionals, ensuring healthcare for a population of 150 million remains a major challenge for the nation. To understand the issues related to shortage of health workforce and healthcare provision, this paper investigates the role of various healthcare providers in provision of health services in Chakaria, a remote rural area in Bangladesh.

METHODS

Data were collected through a survey carried out during February 2007 among 1,000 randomly selected households from 8 unions of Chakaria Upazila. Information on health-seeking behaviour was collected from 1 randomly chosen member of a household from those who fell sick during 14 days preceding the survey.

RESULTS

Around 44% of the villagers suffered from an illness during 14 days preceding the survey and of them 47% sought treatment for their ailment. 65% patients consulted Village Doctors and for 67% patients Village Doctors were the first line of care. Consultation with MBBS doctors was low at 14%. Given the morbidity level observed during the survey it was calculated that 250 physicians would be needed in Chakaria if the patients were to be attended by a qualified physician.

CONCLUSIONS

With the current shortage of physicians and level of production in the country it was asserted that it is very unlikely for Bangladesh to have adequate number of physicians in the near future. Thus, making use of existing healthcare providers, such as Village Doctors, could be considered a realistic option in dealing with the prevailing crisis.

摘要

背景

孟加拉国是世界上卫生人力资源危机的国家之一。面对训练有素的专业人员严重短缺的局面,为 1.5 亿人口提供医疗保健仍然是该国面临的主要挑战。为了了解与卫生人力资源短缺和医疗服务提供有关的问题,本文调查了在孟加拉国一个偏远农村查卡里亚,各种医疗服务提供者在提供卫生服务方面的作用。

方法

2007 年 2 月,在查卡里亚 8 个联盟的 1000 户随机选择的家庭中进行了一项调查,收集了数据。从那些在调查前 14 天生病的家庭中随机选择一名成员,收集了有关寻求医疗行为的信息。

结果

在调查前 14 天,大约有 44%的村民生病了,其中 47%的人因疾病接受了治疗。65%的患者咨询了乡村医生,而 67%的患者将乡村医生视为第一线护理。咨询全科医生的比例仅为 14%。鉴于调查期间观察到的发病率水平,如果要由合格的医生为患者提供治疗,那么查卡里亚需要 250 名医生。

结论

鉴于目前医生的短缺和国家的生产水平,在不久的将来,孟加拉国不太可能拥有足够数量的医生。因此,利用现有的医疗服务提供者,如乡村医生,可以被认为是应对当前危机的一种现实选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a39e/2910021/a67fbd97cb0f/1472-698X-10-18-1.jpg

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