First contact healthcare providers of patients before presenting to a tertiary-level hospital in Bangladesh
Keywords:
Informal healthcare providers, antibiotic use, primary care, BangladeshAbstract
Background: In Bangladesh, many patients seek care from informal healthcare providers before accessing tertiary hospitals due to the limited availability and utilization of formal primary healthcare services. This study aimed to identify the healthcare providers who serve as the first point of contact and to evaluate prescribing patterns at that initial level of care.
Methods: A cross-sectional study was conducted at Prime Medical College in Rangpur, Bangladesh, from 1 January 2024 to 30 June 2024. A total of 197 admitted patients were selected using a simple random sampling technique. Data on socio-demographic characteristics, presenting complaints, first-contact healthcare providers, and medications received prior to hospital presentation were collected and analyzed using SPSS version 26.0.
Results: Among the 197 patients, 61.4% were male, and 74.6% resided in rural areas. Informal healthcare providers were the most common first point of contact (46.2%), followed by registered doctors (42.1%). Fever was the most common presenting complaint (38.1%). Regarding medication use, paracetamol (32.5%) and antibiotics (26.4%) were the most frequently prescribed drugs. Among patients who received antibiotics, 42.3% were prescribed by registered doctors, 40.4% by informal healthcare providers, and 13.5% by pharmacy owners.
Conclusion: Informal healthcare providers remain the primary point of first contact for many patients, particularly in rural areas. Their substantial involvement in antibiotic prescribing highlights the need for stronger regulatory oversight and improved accessibility of formal primary healthcare services to promote rational use of medicines.
J Bangladesh Coll Phys Surg 2026; 44: 147-153
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