Rural Medical Practitioners: Who are They? What Do They Do? Should They Be Trained for Improvement? Evidence from Rural West Bengal

Abstract

Private healthcare sector in rural India is often dominated by unqualified rural medical
practitioners (RMPs). However, there is limited systematic evidence with regard to
RMPs and their potential for an intervention to reduce their harmful practices and
improve quality. This paper presents their brief profile. It critically examines their role
and explore the need for an intervention for harm reduction and quality improvement.
The sample included 104 RMPs, 765 household respondents, 188 Panchayat members
and 48 ANMs. They are examined in terms of their knowledge, attitude and practice
parameters. Results are analysed in the light of evidence from previous studies. Their
knowledge varies by disease but for more than half of the difficult cases they seem to
suggest right medicines. Users are generally satisfied with them with regard to
effectiveness of treatment and price. Panchayat members and ANMs have mixed
opinions but are in favour of a training programme to improve their work. They too feel
the need for training but their expectations vary along with willingness to pay for it.
RMPs are an essential and unavoidable component of rural health care in India, but
their role should not be overemphasized. As a transitional arrangement, the initiative of
training them must be explored but not tuned to institutionalise them so as to attract
more people to join the RMP force.