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‘First we go to the small doctor’: First contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India
BACKGROUND & OBJECTIVES: Against the backdrop of insufficient public supply of primary care and reports of informal providers, the present study sought to collect descriptive evidence on 1(st) contact curative health care seeking choices among rural communities in two States of India - Andhra Pr...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2011
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249960/ https://www.ncbi.nlm.nih.gov/pubmed/22199101 http://dx.doi.org/10.4103/0971-5916.90987 |
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author | Gautham, Meenakshi Binnendijk, Erika Koren, Ruth Dror, David M. |
author_facet | Gautham, Meenakshi Binnendijk, Erika Koren, Ruth Dror, David M. |
author_sort | Gautham, Meenakshi |
collection | PubMed |
description | BACKGROUND & OBJECTIVES: Against the backdrop of insufficient public supply of primary care and reports of informal providers, the present study sought to collect descriptive evidence on 1(st) contact curative health care seeking choices among rural communities in two States of India - Andhra Pradesh (AP) and Orissa. METHODS: The cross-sectional study design combined a Household Survey (1,810 households in AP; 5,342 in Orissa), 48 Focus Group Discussions (19 in AP; 29 in Orissa), and 61 Key Informant Interviews with healthcare providers (22 in AP; 39 in Orissa). RESULTS: In AP, 69.5 per cent of respondents accessed non-degree allopathic practitioners (NDAPs) practicing in or near their village; in Orissa, 40.2 per cent chose first curative contact with NDAPs and 36.2 per cent with traditional healers. In AP, all NDAPs were private practitioners, in Orissa some pharmacists and nurses employed in health facilities, also practiced privately. Respondents explained their choice by proximity and providers’ readiness to make house-calls when needed. Less than a quarter of respondents chose qualified doctors as their first point of call: mostly private practitioners in AP, and public practitioners in Orissa. Amongst those who chose a qualified practitioner, the most frequent reason was doctors’ quality rather than proximity. INTERPRETATION & CONCLUSIONS: The results of this study show that most rural persons seek first level of curative healthcare close to home, and pay for a composite convenient service of consulting-cum-dispensing of medicines. NDAPs fill a huge demand for primary curative care which the public system does not satisfy, and are the de facto first level access in most cases. |
format | Online Article Text |
id | pubmed-3249960 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-32499602012-01-05 ‘First we go to the small doctor’: First contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India Gautham, Meenakshi Binnendijk, Erika Koren, Ruth Dror, David M. Indian J Med Res Original Article BACKGROUND & OBJECTIVES: Against the backdrop of insufficient public supply of primary care and reports of informal providers, the present study sought to collect descriptive evidence on 1(st) contact curative health care seeking choices among rural communities in two States of India - Andhra Pradesh (AP) and Orissa. METHODS: The cross-sectional study design combined a Household Survey (1,810 households in AP; 5,342 in Orissa), 48 Focus Group Discussions (19 in AP; 29 in Orissa), and 61 Key Informant Interviews with healthcare providers (22 in AP; 39 in Orissa). RESULTS: In AP, 69.5 per cent of respondents accessed non-degree allopathic practitioners (NDAPs) practicing in or near their village; in Orissa, 40.2 per cent chose first curative contact with NDAPs and 36.2 per cent with traditional healers. In AP, all NDAPs were private practitioners, in Orissa some pharmacists and nurses employed in health facilities, also practiced privately. Respondents explained their choice by proximity and providers’ readiness to make house-calls when needed. Less than a quarter of respondents chose qualified doctors as their first point of call: mostly private practitioners in AP, and public practitioners in Orissa. Amongst those who chose a qualified practitioner, the most frequent reason was doctors’ quality rather than proximity. INTERPRETATION & CONCLUSIONS: The results of this study show that most rural persons seek first level of curative healthcare close to home, and pay for a composite convenient service of consulting-cum-dispensing of medicines. NDAPs fill a huge demand for primary curative care which the public system does not satisfy, and are the de facto first level access in most cases. Medknow Publications & Media Pvt Ltd 2011-11 /pmc/articles/PMC3249960/ /pubmed/22199101 http://dx.doi.org/10.4103/0971-5916.90987 Text en Copyright: © The Indian Journal of Medical Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Gautham, Meenakshi Binnendijk, Erika Koren, Ruth Dror, David M. ‘First we go to the small doctor’: First contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India |
title | ‘First we go to the small doctor’: First contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India |
title_full | ‘First we go to the small doctor’: First contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India |
title_fullStr | ‘First we go to the small doctor’: First contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India |
title_full_unstemmed | ‘First we go to the small doctor’: First contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India |
title_short | ‘First we go to the small doctor’: First contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India |
title_sort | ‘first we go to the small doctor’: first contact for curative health care sought by rural communities in andhra pradesh & orissa, india |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249960/ https://www.ncbi.nlm.nih.gov/pubmed/22199101 http://dx.doi.org/10.4103/0971-5916.90987 |
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