Training informal health providers can boost healthcare, reveals study

Healthcare

New Delhi: Training of informal health providers, a major component of primary care, can help fill the gap in the rural healthcare system due to huge shortage of medical professionals, a study has suggested.

The study was led by Abhijit Banerjee, professor of Economics at Massachusetts Institute of Technology (MIT) in the US and co-founder J-PAL (Abdul Latif Jameel Poverty Action Lab), along with partners from Liver Foundation, the World Bank and Yale University.

"A rigorous evaluation of a training programme for informal medical practitioners in West Bengal found that contrary to popular perception, the training led to substantial improvements in both knowledge and practice among informal providers," the study says.

The nine-month programme for rural informal practitioners, designed and implemented by Liver Foundation in Birbhum, is aimed at improving the practices of informal providers along the various dimensions of services offered by them.

"Over the 72 classroom sessions, taught by certified medical doctors, the structured curriculum covered topics such as physiology, drug use and abuse, emergency medical care, childcare and antenatal care, as well as public health programmes," a senior official at J-PAL South Asia said.

The researchers believe that training these informal providers can help fill the gap in the healthcare system due to shortage of medical professionals.

J-PAL said it was an intervention programme to analyse the impact of providing training to the informal health providers, and that the study found evidence that training them "did not worsen care, as has been argued by representatives of the Indian Medical Association."

"On the contrary, it found that those offered the training were more likely to correctly manage a case, as well as complete recommended checklists of history questions and examinations. In fact, the training closed half the gap in correct case management relative to the public sector," it said.

The Indian Medical Association's stand has been that it is against any attempt to provide training to informal health providers or 'quacks', saying that they legitimise an illegal activity and dilute standards.

The senior official of the research centre also said that based on the outcome of the study, "the West Bengal government is now in the process of scaling up the training programming to other parts of the state".

The results of this study have been published in the October, 2016, issue of the journal 'Science'.
Informal health providers with no formal medical training are the mainstay of India's primary care system, reportedly providing more than 70 per cent of primary care, the study says.

"The study provides robust evidence on this ongoing debate and shows that medical training can be an effective strategy for improving the quality of care provided by informal providers," Banerjee said.