18 research outputs found
What constitutes responsiveness of physicians: A qualitative study in rural Bangladesh
Responsiveness entails the social actions by health providers to meet the legitimate expectations
of patients. It plays a critical role in ensuring continuity and effectiveness of care
within people centered health systems. Given the lack of contextualized research on
responsiveness, we qualitatively explored the perceptions of outpatient users and providers
regarding what constitute responsiveness in rural Bangladesh. An exploratory study was
undertaken in Chuadanga, a southwestern Bangladeshi District, involving in-depth interviews
of physicians (n = 17) and users (n = 7), focus group discussions with users (n = 4),
and observations of patient provider interactions (three weeks). Analysis was guided by a
conceptual framework of responsiveness, which includes friendliness, respecting, informing
and guiding, gaining trust and optimizing benefits. In terms of friendliness, patients expected
physicians to greet them before starting consultations; even though physicians considered
this unusual. Patients also expected physicians to hold social talks during consultations,
which was uncommon. With regards to respect patients expected physicians to refrain from
disrespecting them in various ways; but also by showing respect explicitly. Patients also had
expectations related to informing and guiding: they desired explanation on at least the diagnosis,
seriousness of illness, treatment and preventive steps. In gaining trust, patients
expected that physicians would refrain from illegal or unethical activities related to patients,
e.g., demanding money against free services, bringing patients in own private clinics by brokers
(dalals), colluding with diagnostic centers, accepting gifts from pharmaceutical representatives.
In terms of optimizing benefits: patients expected that physicians should be
financially sensitive and consider individual need of patients. There were multiple dimensions
of responsiveness- for some, stakeholders had a consensus; context was an important
factor to understand them. This being an exploratory study, further research is
recommended to validate the nuances of the findings. It can be a guideline for responsiveness
practices, and a tipping point for future research
Trente ans de lutte contre lâonchocercose en Afrique de lâOuest. Traitements larvicides et protection de lâenvironnement
La lutte contre l'onchocercose, ou cĂ©citĂ© des riviĂšres, une maladie parasitaire endĂ©mique, fut entreprise en Afrique de l'Ouest dans une perspective do dĂ©veloppement durable. Tous les moyens technologiques disponibles ont de ce fait Ă©tĂ© mobilisĂ©s pour le contrĂŽle du vecteur, une simulie, puis du parasite responsables de cette maladie, par le Programme de Lutte contre lâOnchocercose en Afrique de l'Ouest (OCP). La lutte antivectorielle consistant en Ă©pandages dâinsecticides chimiques sur les sites de dĂ©veloppement de la simulie dans les riviĂšres, il est apparu indispensable dâassurer la sauvegarde de lâenvironnement aquatique qui fournit aux communautĂ©s riveraines eau et ressources biologiques. Les technologies les plus modernes ont Ă©tĂ© mises en Ćuvre dĂšs leur mise au point, pour combattre la maladie, contribuant ainsi Ă la protection de ce milieu. Le programme de surveillance Ă©cologique des riviĂšres traitĂ©es par des larvicides anti-simulies a Ă©tĂ© mis en place dĂšs le lancement dâOCP. et assurĂ© par des spĂ©cialistes de I' hydrobiologie des pays africains participants du Programme, sous la supervision dâun groupe international dâexperts indĂ©pendants, le Groupe Ăcologique. OCP est incontestablement un succĂšs aussi bien pour ce qui est du contrĂŽle de la maladie que de la protection de l'environnement. Il est l'exemple unique au monde dâun programme de santĂ© publique de longue durĂ©e qui depuis son origine a mis en Ćuvre tout ce qui Ă©tait possible pour harmoniser les enjeux de lâamĂ©lioration de la santĂ© et ceux de la protection de lâenvironnement. Il s'est achevĂ© avec la satisfaction de laisser aux gĂ©nĂ©rations montantes un environnement non dĂ©gradĂ© et des vallĂ©es libĂ©rĂ©es de lâonchocercose, qui permettront dâaccroĂźtre la productivitĂ© agricole des pays africains.The control of onchocerciasis, or river blindness, an endemic parasitic disease, was implemented in West Africa in the perspective of sustainable development AH the available technological means to fight this disease, by way of the control of its blackfly vector, then its parasite, were therefore implemented by the Onchocerciasis Control Programme in West Africa (OCP). Vector control being achieved through applications of chemicals on its river breeding sites, it was necessary, at the same time, to fight for the preservation of the aquatic environment, which supplies the communities that live along the rivers with water and biological resources. This was the spirit in which the OCP was set up and implemented, and the most modem technologies were used as they become available to fight the disease, thus facilitating the preservation of the aquatic environment. This Programme has indisputably been a success as regards the control of the disease as also from the point of view of the preservation of the environment The aquatic monitoring programme of the rivers under treatment with anti-simulid larvicides was set up right from the very beginning, and performed by national experts of the Participating Countries of the Programme, under the aegis of a group of international independent experts, the Ecological Croup The Onchocerciasis Control Programme in West Africa is an unique example in the world of a long-term public health programme which has made every effort possible from its inception to adequately combine health and environment issues. It ended with the satisfaction of bequeathing to the coming generations a non degraded environment and valleys freed from onchocerciasis which would increase the agricultural productivity of the countries