Primary care providers and quality of care for diarrhoeal diseases

ABSTRACT

Diarrhoeal diseases are still a major cause of death in children in Pakistan. Therefore, it is necessary that they are not only prevented but are also managed properly, therefore, the main responsibility lies with the private primary level health care providers, also known as General Practitioners [GPs]. This study was conducted to find out the quality of care provided by the GPs for managing diarrhoea. 200 GPs working in squatter areas of four districts, were selected. A vignette of simple viral diarrhoea was given to answer the diagnosis, treatment and advice for that case. Expected standards for management were developed and compared with the answers given by the GPs. The results showed that the GPs followed the standards in diagnosis but their treatment and advice was below standard. The prescribing practice for the management of diarrhoea indicated that though most of them suggested ORS, but it was given with some other drugs [mean number of drugs 2.7 +/- 1.2]. Two thirds of the GPs used at least either an antibiotic or a anti-diarrhoeal. ORS alone was used by 38 GPs. The quality of care given by a majority of GPs for managing diarrhoeal diseases is poor. Thus, there is a need to improve their quality by offering some type of continuing medical education. Further research is also needed to understand the influence of the pharma market on the behaviour of the GPs