Khan Nazib Uz Zaman, Rasheed Sabrina, Sharmin Tamanna, Ahmed Tanvir, Mahmood Shehrin Shaila, Khatun Fatema, Hanifi Sma, Hoque Shahidul, Iqbal Mohammad, Bhuiya Abbas
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
Institute of Development Studies (IDS), University of Sussex, Library Road, Brighton, BN1 9RE, UK.
BMC Med Inform Decis Mak. 2015 Aug 5;15:62. doi: 10.1186/s12911-015-0188-9.
Bangladesh is facing serious shortage of trained health professionals. In the pluralistic healthcare system of Bangladesh, formal health care providers constitute only 5 % of the total workforce; the rest are informal health care providers. Information Communication Technologies (ICTs) are increasingly seen as a powerful tool for linking the community with formal healthcare providers. Our study assesses an intervention that linked village doctors (a cadre of informal health care providers practising modern medicine) to formal doctors through call centres from the perspective of the village doctors who participated in the intervention.
The study was conducted in Chakaria, a remote rural area in south-eastern Bangladesh during April-May 2013. Twelve village doctors were selected purposively from a pool of 55 village doctors who participated in the mobile health (mHealth) intervention. In depth interviews were conducted to collect data. The data were manually analysed using themes that emerged.
The village doctors talked about both business benefits (access to formal doctors, getting support for decision making, and being entitled to call trained doctors) and personal benefits (both financial and non-financial). Some of the major barriers mentioned were technical problems related to accessing the call centre, charging consultation fees, and unfamiliarity with the call centre physicians.
Village doctors saw many benefits to having a business relationship with the trained doctors that the mHealth intervention provided. mHealth through call centres has the potential to ensure consultation services to populations through existing informal healthcare providers in settings with a shortage of qualified healthcare providers.
孟加拉国正面临训练有素的卫生专业人员严重短缺的问题。在孟加拉国多元化的医疗体系中，正规医疗服务提供者仅占劳动力总数的5%；其余为非正规医疗服务提供者。信息通信技术（ICTs）越来越被视为将社区与正规医疗服务提供者联系起来的有力工具。我们的研究从参与干预的乡村医生的角度，评估了一种通过呼叫中心将乡村医生（从事现代医学的非正规医疗服务提供者群体）与正规医生联系起来的干预措施。
该研究于2013年4月至5月在孟加拉国东南部一个偏远农村地区查卡里亚进行。从参与移动健康（mHealth）干预的55名乡村医生中，有目的地挑选了12名乡村医生。通过深入访谈收集数据。使用出现的主题对数据进行人工分析。
乡村医生谈到了商业利益（能够联系正规医生、在决策方面获得支持以及有权呼叫训练有素的医生）和个人利益（包括经济和非经济利益）。提到的一些主要障碍包括与接入呼叫中心相关的技术问题、收取咨询费以及对呼叫中心医生不熟悉。
乡村医生认为与mHealth干预所提供的训练有素的医生建立业务关系有诸多益处。通过呼叫中心的mHealth有潜力通过现有非正规医疗服务提供者，为合格医疗服务提供者短缺地区的人群确保咨询服务。
