Author(s): Jane Putnam
Mentor(s): Melissa Watt
Institution U of U
In low- and middle-income countries, rural populations often look to untrained allopathic practitioners in the informal health sector to address their healthcare needs. In Bangladesh, informal providers called “village doctors” provide the majority of front-line healthcare to the rural poor and are one of the primary sources of antibiotics throughout the country. Pressure and expectations from patients and patient caregivers, coupled with village doctors’ lack of formal medical training and financial incentives for selling antibiotics, likely result in frequent and often unnecessary antibiotic usage, which contributes to community-level antibiotic resistance. The goal of this study was to understand parents’ motivations and expectations when taking a child to a village doctor. We conducted in-depth interviews with parents who took their child to a village doctor (n = 18) and village doctors (n = 18). Interviews explored the role of village doctors in the treatment of pediatric diarrhea, and examined motivations and expectations. . The study was conducted in Southeastern Bangladesh in the Sitakunda Upazila (subdistrict) of the Chattogram District. We used thematic analysis to identify themes related to the motivations and expectations of patient caregivers when bringing their child to a village doctor. Motivating factors for seeking care from a village doctor, as opposed to the formal healthcare system, included: geographic proximity, accessibility, familiarity, and trust. Caregivers expressed an expectation of antibiotics to treat their child’s diarrhea, and village doctors discussed the important role that parents’ expectations play in shaping their treatment practices. In conclusion, village doctors are trusted members of communities and play an important role in meeting local healthcare needs. Understanding the motivations and expectations of parents when taking a child to a village doctor allows us to tailor future initiatives with both communities and village doctors to reduce antibiotic use in children.