Is the practice of public or private sector doctors more evidence-based? A qualitative study from Vellore, India

Akinyemi, Oluwaseun; Martineau, Tim; Tharyan, Prathap

doi:10.1097/xeb.0000000000000042

Cited by 2 publications

(1 citation statement)

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“…One study from Uttar Pradesh, India, including a diverse mix of community health centres, district hospitals, and medical colleges, reported that quality of routine care for uncomplicated deliveries was generally poor but was better in the private compared with the public sector [27]. Another study indicated that knowledge of evidence-based practices seemed to be insufficient in practitioners from both the private and public sector in India [28].…”

Section: Introductionmentioning

confidence: 99%

Care practices and neonatal survival in 52 neonatal intensive care units in Telangana and Andhra Pradesh, India: A cross-sectional study

et al. 2019

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Background The Indian government supports both public- and private-sector provision of hospital care for neonates: neonatal intensive care is offered in public facilities alongside a rising number of private-for-profit providers. However, there are few published reports about mortality levels and care practices in these facilities. We aimed to assess care practices, causes of admission, and outcomes from neonatal intensive care units (NICUs) in public secondary and private tertiary hospitals and both public and private medical colleges enrolled in a quality improvement collaborative in Telangana and Andhra Pradesh—2 Indian states with a respective population of 35 and 50 million. Methods and findings We conducted a cross-sectional study between 30 May and 26 August 2016 as part of a baseline evaluation in 52 consenting hospitals (26 public secondary hospitals, 5 public medical colleges, 15 private tertiary hospitals, and 6 private medical colleges) offering neonatal intensive care. We assessed the availability of staff and services, adherence to evidence-based practices at admission, and case fatality after admission to the NICU using a range of tools, including facility assessment, observations of admission, and abstraction of registers and telephone interviews after discharge. Our analysis is adjusted for clustering and weighted for caseload at the hospital level and presents findings stratified by type and ownership of hospitals. In total, the NICUs included just over 3,000 admissions per month. Staffing and infrastructure provision were largely according to government guidelines, except that only a mean of 1 but not the recommended 4 paediatricians were working in public secondary NICUs per 10 beds. On admission, all neonates admitted to private hospitals had auscultation (100%, 19 of 19 observations) but only 42% (95% confidence interval [CI] 25%–62%, p -value for difference is 0.361) in public secondary hospitals. The most common single cause of admission was preterm birth (25%) followed by jaundice (23%). Case-fatality rates at age 28 days after admission to a NICU were 4% (95% CI 2%–8%), 15% (9%–24%), 4% (2%–8%) and 2% (1%–5%) (Chi-squared p = 0.001) in public secondary hospitals, public medical colleges, private tertiary hospitals, and private medical colleges, respectively, according to facility registers. Case fatality according to postdischarge telephone interviews found rates of 12% (95% CI 7%–18%) for public secondary hospitals. Roughly 6% of admitted neonates were referred to another facility. Outcome data were missing for 27% and 8% of admissions to private tertiary hospitals and private medical colleges. Our study faced the limitation of missing data due to incomplete documentation. Further generalizability was limited due to the small sample size among private facilities. Conclusions Our findings suggest differences in quality of neonatal intensive care and 28-day su...

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Section: Introductionmentioning

confidence: 99%

Care practices and neonatal survival in 52 neonatal intensive care units in Telangana and Andhra Pradesh, India: A cross-sectional study

et al. 2019

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Information needs and sources of health professionals in Malawi

Gama,

Chawinga,

Chipeta

2023

Health Info Libraries J

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BackgroundHealth professionals require up‐to‐date information in their pursuit of evidence‐based practice in health care. There is a plethora of literature on information behaviour of different user groups across disciplines in Malawi with little evidence on health professionals.ObjectivesThe study investigated the information behaviour of health professionals at one of the three biggest hospitals in Malawi.MethodsA descriptive survey design was used. Ninety‐four health professionals participated in the study. SPSS was used for descriptive analysis to generate frequencies and percentages.ResultsPersonal and professional development constituted the major information need among all the health professionals. Health professionals used books and colleagues as sources of information, but many preferred to use websites, rather than print resources. The challenges that affected their information behaviour included, inadequate information resources, limited access to the internet and e‐databases, and lack of information literacy skills.DiscussionThe study revealed various information needs of health professionals and their preferred information sources. Health professionals need adequate library and information services with both print and digital resources and support from information professionals. Nevertheless, use of the hospital library was very low among health professionals.ConclusionHealth professionals at MCH continue to face various challenges that hinder access and efficient use of information resources.

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Is the practice of public or private sector doctors more evidence-based? A qualitative study from Vellore, India

Cited by 2 publications

References 30 publications

Care practices and neonatal survival in 52 neonatal intensive care units in Telangana and Andhra Pradesh, India: A cross-sectional study

Care practices and neonatal survival in 52 neonatal intensive care units in Telangana and Andhra Pradesh, India: A cross-sectional study

Information needs and sources of health professionals in Malawi

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