According to the World Health Organization (WHO), 57 nations throughout the world are experiencing a doctor shortage due to health professional imbalance and maldistribution. The goal of this study is to see if substitution can be done in the mainstream of health systems to help developing countries alleviate health workforce syndrome. Six facilities were chosen at random (two union health family welfare centers, two Upazilla health complexes, and two clinics run by non-governmental organizations). In-depth interviews and observation were conducted using a standardized questioner that addressed 111 factors for the Essential service package. To emphasis on substitution, crises, and policy implications, a hypothetical framework was employed. According to the study report, the majority of services given by doctors in public health facilities were the same services offered by non-doctor health care workers in health care facilities managed by non-government organizations in seven components of the Essential Service Package. Even for non-communicable illness screening, non-doctor health care practitioners are not permitted to participate. The findings of the study show that non-doctor health care service providers’ competency and expertise in the areas of maternal and child health, adolescent care, nutritional care, and other disease care are gold standard. In terms of maternal health care, Non-doctor health care providers were unable to serve and were referred cases of identify obstetric emergencies (ANC7), labor induction (ND4), episiotomy (ND7), and identify and manage obstetric emergencies (isolation or B/CEmonC), obstructed labor, pre/eclampsia, haemorrhage, pre-term labor, including administration of antenatal Corticosteroids (ND8) and complicated cases (ND9) (PNC4). Non-doctor newborn care providers are unable to manage preterm or low birth weight (LBW) neonates (INC4), Identification and management of sepsis (NCD5), omphalitis (NCD6), LBW babies (refer 1, 800 (NCD7), identification and management of newborn jaundice (NCD8), and obs and neonatal emergencies. Advocacy and awareness development on PPFP and post-MR/PAC–FP (FP2), menstruation regulation (FP11), post-abortion FP (FP12), post-partum FP (FP13), post-MR–FP (FP14), and management of contraceptive complications are among the family planning services that non-doctor providers at NGO clinics do not provide (FP15). Following book chart let, non-doctor health care service providers covered IMCI and EPI well. Non-doctor health-care service providers are well-equipped to perform the essential service package’s services (ESP). If they were given further training, they would be able to provide more services that are currently not covered, and doctors would be able to focus on more complex patients. If a particular cadre (non-doctor/paramedics) is established in the mainstream of health-care systems, the public health sector’s service range will expand, and universal health coverage will be achieved.
Author (s) Details
Institute of Health Economics, University of Dhaka, Bangladesh.
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