Health Status, Treatment and Drug Use in Rural Bangladesh: A Case Study of a Village

Abstract

In Bangladesh, the government healthcare system remains a very minor source of health care for rural households. The availability of registered physicians is scare in rural areas, and the people, the majority of whom are underweight as indicated by body mass index measurement have to depend on pharmacy salespersons, quacks and herbal or spiritual healers. Unlike Australia, almost every pharmacy salesperson illegally recommends and sells prescription medicines. In addition, there are also unqualified village 'doctors' who do not own a pharmacy shop but provide written prescriptions. However, the treatments provided by these village 'doctors' remain open to question, with instances of maltreatment or inadequate treatment. The treatments are mostly symptomatic and polypharmacy is common, with antibiotics and vitamins prescribed widely. On the other hand, rural people sometimes do not buy all the drugs that are prescribed for them, partly because of financial constraint. In addition, self-medication is common. While family planning and immunisation are slowly becoming popular among rural families, general health knowledge is still poor. Public healthcare campaigns as well as proper training for the rural prescribers could be helpful in improving the present poor rural healthcare system.

Changing consumption patterns in rural Bangladesh

“…They now often visit a doctor, if needed, but MBBS doctors are few; most are village doctors (with no formal medical education) who prescribe medicine based on their own experience and on some advertisements or booklets from pharmaceutical companies. They place greater emphasis on immediate cures and rely mostly on antibiotics and vitamins (Roy, 1997). In most cases, because there is no separate fee for a visit; these doctors charge higher prices for medicines to supplement their lower fees.…”

Factors Influencing Clinician’s Antibiotic Prescribing Behaviors (APB) in Bangladesh: An In-Depth Review Using COMB Model

“…12 The common patient factors involved lack of knowledge between bacterial and viral infections, expectation, satisfaction and compliance with an antibiotic prescription, notions of antibiotics effectiveness, mutual recognition, patient's pressure, the possibility of losing patients are directly associated with prescribers antibiotic prescribing behavior. 10,13,22 Consumer's ignorance, self-medication behavior, and OTC antibiotics selling aggravate misuse -100, 000 doses of antibiotics had been dispensed without a prescription in one month at Rajbari district of Bangladesh. 22 Besides, patient volume and limited time of prescribers both in public and private hospital settings are another major problem area.…”

“…10,13,22 Consumer's ignorance, self-medication behavior, and OTC antibiotics selling aggravate misuse -100, 000 doses of antibiotics had been dispensed without a prescription in one month at Rajbari district of Bangladesh. 22 Besides, patient volume and limited time of prescribers both in public and private hospital settings are another major problem area. Average consultation time per patient in the primary care of Bangladesh is only 54 seconds.…”

Study on the Pattern of Antibiotic Use Including the Resistance Episodes in Bangladesh

“…A survey in Rajbari district found that 1,00,000 antibiotic doses had been dispensed in a month without any prescription. 5 Another study depicts that on an average, 92% of medications dispensed from the pharmacies were without any prescription. 6 Currently most of the drugs in Bangladesh are prescribed or sold by non-qualified or relatively less qualified health workers.…”