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Permanent URI for this collectionhttps://hdl.handle.net/10361/6268

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Users discourses about primary health care professionals in rural Bangladesh
(© 2014 Department of Public Health, School of Public Health and Psychosocial Studies, Auckland University of Technology, 2014-12) Hasan, Md. Kamrul; Conn, Cath; Wilson, Kaisa
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.
Quality of primary health care services in rural Bangladesh: patients’ perspectives
(© 2012 Ontario International Development Agency, Canada, 2012-03-31) Hasan, Md. Kamrul
A key aim of the health policy of the Government of Bangladesh (GoB) has been to provide quality health services to all its citizens. In line with the policy objective, the GoB has adopted the primary health care (PHC) approach as a health development strategy. Inspired by the Alma Ata Declaration on PHC, the GoB health policy and programmes aim at ensuring “health for all” (Perry, 2000), with special focus on rural population and the poor. There is now a common mistrust of the public health services in the country and the perceived poor quality of health services push the higher socio-economic groups to seek health services abroad (Mahdy, 2009). I used a narrative interview method to better understand the user perspectives on the quality of PHC to register patients’ voices missed in previous predominantly quantitative studies (e.g., Sohail, 2005). Data for the research came from 10 ex-patients who sought primary health services in a health centre in a sub-district in Bangladesh. This paper demonstrates that lack of adequate health professionals, misuse of resources, provider absenteeism, provider-centric consultations result in patient dissatisfaction and ineffectiveness of services. I argue that there is a need for proper maintenance of resources, better monitoring and supervision and address process-related quality issues to ensure better quality health services for the rural people.
AIDS-related stigma in Thailand
(© 2012 SAGE Publications, 2012-07) Hasan, Md. Kamrul
Since the emergence of the HIV/AIDS pandemic, a growing body of research literature documented HIV/AIDS-related stigma and discrimination in Thailand and elsewhere. The purpose of this study was to better understand community attitudes towards persons living with HIV/AIDS (PLWHAs) in the context of the decreasing rates of HIV/AIDS infection and the HIV/AIDS intervention programs in Thailand. This study applies focus group discussion method to investigate community attitudes towards the PLWHAs in a Northern Thai district. Research participants comprised both non-infected community people and HIV-positive people in the district which has a relatively high concentration of PLWHAs. The study indicates that despite remarkable positive changes in the community attitudes, stigma and discrimination were still persisting in different spheres of community life. It also indicates that PLWHAs also self-stigmatise themselves. Policy options for fighting AIDS-related stigma are discussed.

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