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Experience of using mHealth to link village doctors with physicians: lessons from Chakaria, Bangladesh.

Khan NU, Rasheed S, Sharmin T, Ahmed T, Mahmood SS, Khatun F, Hanifi S, Hoque S, Iqbal M, Bhuiya A - BMC Med Inform Decis Mak (2015)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. nazib@icddrb.org.

ABSTRACT

Background: 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.

Methods: 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.

Result: 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.

Conclusion: 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.

No MeSH data available.


Related in: MedlinePlus

TRCL service structure
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Fig1: TRCL service structure

Mentions: Information communication technologies (ICTs), such as mobile phones and the internet are rapidly proliferating in the developing world [15] and people are increasingly seeing ICTs as powerful tools for improving efficiency in the health sector. Mobile phones have been used to improve adherence to treatment guidelines [16] and to facilitate health workers providing care for patients [17–19]. In some programmes mobile phones have been used to increase communication both between patients and health workers, and between health workers and managers, to improve surveillance of conditions and monitoring of health products, prescriptions, and adherence to prescription guidelines [20, 21]. In Chakaria, Bangladesh, Telemedicine Reference Centre (TRCL), a private company [22] designed and implemented an mHealth intervention in 2011. The village doctors could register through a free phone call to be linked with trained physicians based at call centres. When patients sought health care from these registered village doctors, the village doctors could call the call centres for consultation. The patients were charged BDT 30 (USD 0.40) [23] for the call and the prescription from call centre was sent by SMS to the village doctor’s phone. The revenue collected from the patients was shared between the call centre and the village doctors (BDT 18 and 12 respectively) (Fig. 1). During the project period 55 village doctors were registered and 215 calls were made to the call centre [23]. The project stopped operation in early 2013 as the number of calls received from the village doctors was deemed inadequate for the business. Our study objective was to assess the mHealth intervention implemented by TRCL from the village doctors’ perspective.Fig. 1


Experience of using mHealth to link village doctors with physicians: lessons from Chakaria, Bangladesh.

Khan NU, Rasheed S, Sharmin T, Ahmed T, Mahmood SS, Khatun F, Hanifi S, Hoque S, Iqbal M, Bhuiya A - BMC Med Inform Decis Mak (2015)

TRCL service structure
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4526289&req=5

Fig1: TRCL service structure
Mentions: Information communication technologies (ICTs), such as mobile phones and the internet are rapidly proliferating in the developing world [15] and people are increasingly seeing ICTs as powerful tools for improving efficiency in the health sector. Mobile phones have been used to improve adherence to treatment guidelines [16] and to facilitate health workers providing care for patients [17–19]. In some programmes mobile phones have been used to increase communication both between patients and health workers, and between health workers and managers, to improve surveillance of conditions and monitoring of health products, prescriptions, and adherence to prescription guidelines [20, 21]. In Chakaria, Bangladesh, Telemedicine Reference Centre (TRCL), a private company [22] designed and implemented an mHealth intervention in 2011. The village doctors could register through a free phone call to be linked with trained physicians based at call centres. When patients sought health care from these registered village doctors, the village doctors could call the call centres for consultation. The patients were charged BDT 30 (USD 0.40) [23] for the call and the prescription from call centre was sent by SMS to the village doctor’s phone. The revenue collected from the patients was shared between the call centre and the village doctors (BDT 18 and 12 respectively) (Fig. 1). During the project period 55 village doctors were registered and 215 calls were made to the call centre [23]. The project stopped operation in early 2013 as the number of calls received from the village doctors was deemed inadequate for the business. Our study objective was to assess the mHealth intervention implemented by TRCL from the village doctors’ perspective.Fig. 1

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. nazib@icddrb.org.

ABSTRACT

Background: 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.

Methods: 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.

Result: 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.

Conclusion: 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.

No MeSH data available.


Related in: MedlinePlus