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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Rao, Krishna D. Sundararaman, T. Bhatnagar, Aarushi Gupta, Garima Kokho, Puni Jain, Kamlesh |
| Spatial Coverage | India |
| Description | Country affiliation: India Author Affiliation: Rao KD ( Public Health Foundation of India, ISID Campus, India. kd.rao@phfi.org) |
| Abstract | The scarcity of rural physicians in India has resulted in non-physician clinicians (NPC) serving at primary health centers (PHC). This study examines the clinical competence of NPCs and physicians serving at PHCs to treat a range of medical conditions. The study is set in Chhattisgarh state, where physicians (medical officers) and NPCs: Rural Medical Assistants (RMA), and Indian system of medicine physicians (AYUSH Medical Officers) serve at PHCs. Where no clinician is available, Paramedics (pharmacists and nurses) usually provide care. In 2009, PHCs in Chhattisgarh were stratified by type of clinical care provider present. From each stratum a representative sample of PHCs was randomly selected. Clinical vignettes were used to measure provider competency in managing diarrhea, pneumonia, malaria, TB, preeclampsia and diabetes. Prescriptions were analyzed. Overall, the quality of medical care was low. Medical Officers and RMAs had similar average competence scores. AYUSH Medical Officers and Paramedicals had significantly lower average scores compared to Medical Officers. Paramedicals had the lowest competence scores. While 61% of Medical Officer and RMA prescriptions were appropriate for treating the health condition, only 51% of the AYUSH Medical Officer and 33% of the prescriptions met this standard. RMAs are as competent as physicians in primary care settings. This supports the use of RMA-type clinicians for primary care in areas where posting Medical Officers is difficult. AYUSH Medical Officers are less competent and need further clinical training. Overall, the quality of medical care at PHCs needs improvement. |
| File Format | HTM / HTML |
| ISSN | 02779536 |
| e-ISSN | 18735347 |
| Journal | Social Science & Medicine |
| Volume Number | 84 |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2013-05-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Discipline Medicine Allied Health Personnel Clinical Competence Statistics & Numerical Data Physicians, Primary Care Primary Health Care Organization & Administration Quality Of Health Care Cross-sectional Studies Health Services Research Rural Health Services Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine Health (social science) History and Philosophy of Science |
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