The impact of training informal health care providers in India: A randomized controlled trial

Health care providers without formal medical qualifications provide more than 70% of all primary care in rural India. Training these informal providers may be one way to improve the quality of care where few alternatives exist. We report on a randomized controlled trial assessing a program that prov...

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Bibliographic Details
Published in:Science (American Association for the Advancement of Science) Vol. 354; no. 6308
Main Authors: Das, Jishnu, Chowdhury, Abhijit, Hussam, Reshmaan, Banerjee, Abhijit V
Format: Journal Article
Language:English
Published: United States 07.10.2016
Subjects:
Anti-Bacterial Agents
Chest Pain - drug therapy
Child
Diarrhea - drug therapy
Drug Prescriptions
Drug Utilization - statistics & numerical data
Health Personnel - economics
Health Personnel - education
Humans
India
Inservice Training
Patient Care
Primary Health Care
Quality Improvement
Respiratory Distress Syndrome, Adult - drug therapy
Rural Population
Unnecessary Procedures - statistics & numerical data
ISSN:1095-9203
Online Access:Get more information
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Summary:Health care providers without formal medical qualifications provide more than 70% of all primary care in rural India. Training these informal providers may be one way to improve the quality of care where few alternatives exist. We report on a randomized controlled trial assessing a program that provided 72 sessions of training over 9 months to 152 informal providers (out of 304). Using standardized patients ("mystery clients"), we assessed clinical practice for three different conditions to which both providers and trainers were blinded during the intervention, representative of the range of conditions that these providers normally diagnose and treat. Training increased correct case management by 7.9 percentage points (14.2%) but did not affect the use of unnecessary medicines and antibiotics. At a program cost of $175 per trainee, our results suggest that multitopic medical training offers an effective short-run strategy to improve health care.
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ISSN:1095-9203
DOI:10.1126/science.aaf7384