The impact of training informal health care providers in India: A randomized controlled trial
The impact of training informal health care providers in India: A randomized controlled trial
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DOI：
10.1126/science.aaf7384
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发表时间：
2016-10-07
期刊：
影响因子：
56.9
通讯作者：
Banerjee, Abhijit V.
中科院分区：
文献类型：
--
作者：
Das, Jishnu;Chowdhury, Abhijit;Banerjee, Abhijit V.
在印度农村，没有正式医疗资格的卫生保健提供者提供了70%以上的初级保健。培训这些非正式的提供者可能是在几乎没有其他选择的情况下提高护理质量的一种方法。我们报告了一项随机对照试验，评估了一项在9个月内向152名非正式提供者（共304名）提供72次培训的计划。使用标准化的患者（“神秘客户”），我们评估了三种不同情况的临床实践，提供者和培训人员在干预期间均不知情，代表了这些提供者通常诊断和治疗的情况范围。培训使正确的病例管理增加了7.9个百分点（14.2%），但不影响不必要的药物和抗生素的使用。在每名受训者175美元的计划成本，我们的研究结果表明，多主题的医疗培训提供了一个有效的短期战略，以改善医疗保健。
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.