Users discourses about primary health care professionals in rural Bangladesh

Abstract

Evidence from earlier studies in Bangladesh indicates that an imbalance in status between health professionals and primary healthcare users in rural Bangladesh can lead to corrupt behaviour among health professionals. This behaviour, it has been shown, may negatively impact on the quality of primary health care (PHC) and health outcomes among those using the service. Using narrative interviews with a small sample of PHC users, in a rural population in Bangladesh this study sought to explore the ways in which participants discussed the quality of healthcare provided by their local PHC facility. Issues raised by participants in interviews included misuse of resources and embezzlement of state funding, particularly by doctors. These abuses were buttressed by discourses in local communities – and indeed it has been shown in many other communities – in which healthcare professionals are treated as acting within ethical boundaries. However participants in this study expressed dissatisfaction with what they characterised as the corrupt behaviour of health professionals, and displayed resistance to this in the context of the interview.