Children in rural India are treated wrongly for diarrhea and pneumonia, which are the two leading killers of young ones worldwide, revealed researchers at Duke University.
Lead author of the study Manoj Mohanan said, "Medical practitioners typically fail to prescribe lifesaving treatments such as oral rehydration salts (ORS). Instead, they typically prescribe unnecessary antibiotics or other potentially harmful drugs. 80 percent medical providers in their study had no medical degree. But much of India's rural population receives care from such untrained providers, and very few studies have been able to rigorously measure the gap between what providers know and what they do in practice."
The study involved 340 health care providers in Bihar, wherein researchers conducted 'vignette' interviews with providers to assess how they would diagnose and treat a hypothetical case. Later, standardized patients, individuals who portrayed patients presenting the same symptoms as in the interviews, made unannounced visits at the clinics. This strategy enabled researchers to measure the gap between what healthcare providers know and what they actually do.
The research found that providers exhibited low levels of knowledge about both diarrhea and pneumonia during the interviews and performed even worse in practice. In practice, none of them gave the correct treatment- only ORS, with or without zinc, and no other potentially harmful drugs. Instead, almost 72 percent of healthcare providers gave antibiotics or potentially harmful treatments without ORS.
The results show that in order to reduce child mortality, there was a need of strategies to improve diagnosis and treatment of these two childhood illnesses. Mohanan said, "They needed to understand what incentives cause providers to diverge from proper diagnosis and treatment."
The study appears online in JAMA Pediatrics.