Amin R, Chowdhury S A, Kamal G M, Chowdhury J
Institute for Urban Research, Morgan State University, Baltimore, MD 21239.
Soc Sci Med. 1989;29(12):1343-9. doi: 10.1016/0277-9536(89)90234-7.
The study, which is based on data from two household level health surveys conducted in 1976 and 1987 in the Companiganj area of rural Bangladesh, examines the premise that the utilization of public health care services can be increased by increasing the availability and accessibility of effective medicines to the public and by improving the disease recognition and management by the health practitioners. The results of the study suggest that the availability and accessability of modern effective medicines through the provision of decentralized community-based rural health services, by a well-trained and well-managed field personnel structure, had an incremental impact on the utilization of modern health care from a rural health center and its subcenters. The study further reveals that, in 1976 as well as in 1987, the overwhelming majority of the rural Bangladesh population were using modern Western medical practitioners, although most of these practitioners were informally trained or self-trained without any formal medical degrees or training. It is concluded that the persons responsible for health program planning and health program implementation need to ensure that the access to basic public health care services be made broad enough to cover the majority of the rural population through a system of decentralized curative and preventive services, as well as through a system of adequate training and deployment of health professionals, including training programs to improve the quality of medical services offered by the informal and self-trained practitioners of modern medicines.
该研究基于1976年和1987年在孟加拉国农村地区的Companiganj开展的两项家庭层面健康调查数据，检验了这样一个前提，即通过增加有效药物对公众的可及性和可得性，以及通过提高卫生从业人员对疾病的识别和管理能力，可以提高公共卫生保健服务的利用率。研究结果表明，通过由训练有素且管理良好的现场人员结构提供分散的基于社区的农村卫生服务，现代有效药物的可及性和可得性对农村卫生中心及其分中心的现代卫生保健利用率产生了增量影响。该研究进一步揭示，在1976年以及1987年，孟加拉国农村的绝大多数人口都在使用现代西医从业者，尽管这些从业者大多是未经正规培训或自学成才，没有任何正规医学学位或培训。研究得出结论，负责卫生项目规划和实施的人员需要确保通过分散的治疗和预防服务系统，以及通过对卫生专业人员进行充分培训和部署的系统，包括提高现代医学非正规和自学从业者提供的医疗服务质量的培训项目，使基本公共卫生保健服务的可及性足够广泛，以覆盖大多数农村人口。
