Mailankody Pooja, Parthasarathy Rajani, Randeep D, Rao Girish N, Paplikar Avanthi, Johnson Annie Nithiya Vathani, Varghese Feba, Govindaraj Sarath, Shahed Rehan, Vasudev Aparna, Boopalan Deenadayalan, Kulkarni Girish B, Kalkonde Yogeshwar, Sinha Sanjib, Alladi Suvarna
Department of Neurology, National Institute of Mental Health and Neurosciences, Karnataka, India.
Department of Health and Family Welfare, Government of Karnataka, Karnataka, India.
J Family Med Prim Care. 2024 Sep;13(9):3719-3729. doi: 10.4103/jfmpc.jfmpc_1984_23. Epub 2024 Sep 11.
Neurological disorders are the leading causes of death and disability globally. In low-middle-income countries such as India, there is a wide treatment gap for neurological disorders. To address this gap, an initiative known as the Karnataka Brain Health Initiative (KaBHI) was developed in collaboration with the public health system of the state of Karnataka in India.
A structured hybrid training program was conducted for 120 medical doctors working in the Primary Health Centers (PHCs) in the public health system in three districts of Karnataka. Pre- and post-training evaluation was conducted to assess physicians' knowledge and skills for evaluating patients with common neurological conditions.
Of 120 PHC doctors, 111 (92%) scored below the passing score of 50 points out of 100 before the training program. After the training, all trainees scored above this cut-off. The study found a significant improvement in knowledge and skills after the training (before training: 40.48 ± 7.92, after training: 66.28 ± 8.98 ( < 0.001) mean difference = 25.81), and was comparable among the PHC doctors in all three districts.
Our study shows the feasibility of training primary care doctors in the public health system to manage selected common neurological disorders. The training program can potentially help to reduce the treatment gap for neurological disorders in India.
神经系统疾病是全球死亡和残疾的主要原因。在印度等中低收入国家,神经系统疾病的治疗差距很大。为了弥补这一差距,印度卡纳塔克邦与该邦的公共卫生系统合作开展了一项名为卡纳塔克邦脑健康倡议(KaBHI)的项目。
为卡纳塔克邦三个地区公共卫生系统基层医疗中心(PHC)的120名医生开展了一个结构化混合培训项目。进行了培训前和培训后的评估,以评估医生评估常见神经系统疾病患者的知识和技能。
在120名基层医疗中心医生中,111名(92%)在培训项目前的100分制考试中得分低于及格分数50分。培训后,所有学员的得分均高于这一分数线。研究发现培训后知识和技能有显著提高(培训前:40.48±7.92,培训后:66.28±8.98(<0.001),平均差异=25.81),并且在所有三个地区的基层医疗中心医生中具有可比性。
我们的研究表明,培训公共卫生系统中的基层医疗医生来管理某些常见神经系统疾病是可行的。该培训项目可能有助于缩小印度神经系统疾病的治疗差距。