Understanding variations in diarrhea management across healthcare facilities in Bangladesh: a formative qualitative study.
Bangladesh
LMICs
cholera
diarrhea
qualitative
resources
Journal
Journal of infection in developing countries
ISSN: 1972-2680
Titre abrégé: J Infect Dev Ctries
Pays: Italy
ID NLM: 101305410
Informations de publication
Date de publication:
31 05 2023
31 05 2023
Historique:
received:
17
08
2022
accepted:
14
02
2023
medline:
8
6
2023
pubmed:
6
6
2023
entrez:
6
6
2023
Statut:
epublish
Résumé
Acute diarrhea remains a leading cause of morbidity and mortality with over 6.3 billion cases and 1.3 million deaths annually. Despite the existence of standardized guidelines for diarrhea management, wide variability in clinical practice exists, particularly in resource-limited settings. The goal of this study was to qualitatively explore how diarrhea management in Bangladesh varies according to resource availability, clinical setting, and provider roles. This was a secondary analysis of a cross-sectional qualitative study conducted in three diverse hospital settings (district hospital, subdistrict hospital, and specialty diarrhea research hospital) in Bangladesh. A total of eight focus group discussions with nurses and physicians were conducted. Applied thematic analysis was used to identify themes regarding variations in diarrhea management. Of the 27 focus group participants, 14 were nurses and 13 doctors; 15 worked in a private diarrhea specialty hospital and 12 worked in government district or subdistrict hospitals. Several key themes emerged from the qualitative data analysis: 1) priorities in the clinical assessment of diarrhea 2) use of guidelines versus clinical judgment; 3) variability in clinician roles and between clinical settings influences care delivery; 4) impact of resource availability on diarrhea management; and 5) perceptions of community health workers' role in diarrhea management. Findings from this study may aid in informing interventions to improve and standardize diarrhea management in resource-constrained settings. Resource availability, practices regarding diarrhea assessment and treatment, provider experience, and variability in provider roles are essential considerations when developing clinical tools in low- and middle- income countries.
Identifiants
pubmed: 37279426
doi: 10.3855/jidc.17260
pmc: PMC10394709
mid: NIHMS1918723
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
665-676Subventions
Organisme : NIDDK NIH HHS
ID : R01 DK116163
Pays : United States
Informations de copyright
Copyright (c) 2023 Nour Elshabassi, Stephanie C Garbern, Rochelle K Rosen, Monique Gainey, Sabiha Nasrin, Nur H Alam, Sufia Sultana, Tahmida Hasnin, Adam C Levine.
Déclaration de conflit d'intérêts
No Conflict of Interest is declared
Références
PLoS Negl Trop Dis. 2010 Aug 03;4(8):e768
pubmed: 20689809
Health Policy. 2007 Dec;84(2-3):332-43
pubmed: 17618702
Health Policy Plan. 2000 Mar;15(1):95-102
pubmed: 10731240
R I Med J (2013). 2019 Sep 3;102(7):36-39
pubmed: 31480818
J Urban Health. 2019 Apr;96(2):193-207
pubmed: 30159634
Am J Surg. 2021 May;221(5):918-922
pubmed: 33070983
J Epidemiol Community Health. 2004 Apr;58(4):315-20
pubmed: 15026446
Bull World Health Organ. 2011 Aug 1;89(8):583-93
pubmed: 21836757
Int J Equity Health. 2017 Nov 13;16(1):197
pubmed: 29132365
Epidemiology. 2008 Jan;19(1):103-10
pubmed: 18091420
PLoS Negl Trop Dis. 2017 Jan 19;11(1):e0005290
pubmed: 28103233
PLoS One. 2013 Sep 25;8(9):e75261
pubmed: 24086485
Lancet Digit Health. 2020 May;2(5):e250-e258
pubmed: 33328057
Hum Resour Health. 2011 Jan 22;9:3
pubmed: 21255446
Glob Health Sci Pract. 2015 Aug 18;3(3):405-18
pubmed: 26374802
J Glob Health. 2019 Dec;9(2):020803
pubmed: 31673347
Soc Sci Med. 2020 Sep;260:113185
pubmed: 32712557
JMIR Hum Factors. 2022 Mar 25;9(1):e33325
pubmed: 35333190
Lancet Infect Dis. 2017 Sep;17(9):909-948
pubmed: 28579426
Psyche (Camb Mass). 2019;2019:4954095
pubmed: 33281233
Vaccine. 2020 Feb 29;38 Suppl 1:A18-A24
pubmed: 31326255
Transl Pediatr. 2021 Oct;10(10):2646-2665
pubmed: 34765491
Int J Equity Health. 2016 Oct 10;15(1):167
pubmed: 27724955
J Infect Dis. 2018 Oct 15;218(suppl_3):S171-S172
pubmed: 30169839
Soc Sci Med. 2004 Nov;59(10):2025-36
pubmed: 15351470
PLoS Negl Trop Dis. 2021 Mar 10;15(3):e0009266
pubmed: 33690646
Soc Sci Med. 2007 Mar;64(6):1166-77
pubmed: 16890336
Trop Med Health. 2021 May 10;49(1):34
pubmed: 33966631
PLoS One. 2022 Aug 26;17(8):e0273862
pubmed: 36018895
Int J Epidemiol. 2010 Apr;39 Suppl 1:i75-87
pubmed: 20348131
J Biosoc Sci. 2019 Jul;51(4):578-590
pubmed: 30565530
Lancet Glob Health. 2016 Oct;4(10):e744-51
pubmed: 27567350