Health status, treatment and drug use in rural Bangladesh: a case study of a village.

In Bangladesh, the government healthcare system remains a very minor source of health care for rural households. The availability of registered physicians is scare in rural areas, and the people, the majority of whom are underweight as indicated by body mass index measurement have to depend on pharmacy salespersons, quacks and herbal or spiritual healers. Unlike Australia, almost every pharmacy salesperson illegally recommends and sells prescription medicines. In addition, there are also unqualified village 'doctors' who do not own a pharmacy shop but provide written prescriptions. However, the treatments provided by these village 'doctors' remain open to question, with instances of maltreatment or inadequate treatment. The treatments are mostly symptomatic and polypharmacy is common, with antibiotics and vitamins prescribed widely. On the other hand, rural people sometimes do not buy all the drugs that are prescribed for them, partly because of financial constraint. In addition, self-medication is common. While family planning and immunisation are slowly becoming popular among rural families, general health knowledge is still poor. Public healthcare campaigns as well as proper training for the rural prescribers could be helpful in improving the present poor rural healthcare system.