Are 'Village Doctors' in Bangladesh a curse or a blessing?

Data were collected through a survey carried out during February 2007 among 1,000 randomly selected households from 8 unions of Chakaria Upazila. Information on health-seeking behaviour was collected from 1 randomly chosen member of a household from those who fell sick during 14 days preceding the survey.Around 44% of the villagers suffered from an illness during 14 days preceding the survey and of them 47% sought treatment for their ailment. 65% patients consulted Village Doctors and for 67% patients Village Doctors were the first line of care. Consultation with MBBS doctors was low at 14%. Given the morbidity level observed during the survey it was calculated that 250 physicians would be needed in Chakaria if the patients were to be attended by a qualified physician.With the current shortage of physicians and level of production in the country it was asserted that it is very unlikely for Bangladesh to have adequate number of physicians in the near future. Thus, making use of existing healthcare providers, such as Village Doctors, could be considered a realistic option in dealing with the prevailing crisis.Bangladesh has an acute shortage of health workforce to provide health services to its 150 million people [1]. A nationwide survey in 2007 estimated that there is a shortage of 60,000 physicians, 280,000 nurses and 483,000 technologists in the country. With the current level of production, it is very unlikely that the nation will recover this shortage in near future [2]. The current composition of the health workforce in the country is dominated by informal providers, constituting 95% of total workforce and the share of the trained professionals is low at 5% [2]. The number of informal healthcare providers, especially the Village Doctors, has increased phenomenally during the last decade which clearly indicates an increasing market demand. With ongoing emphasis on expansion of the public-sector health services, manned by formally trained providers, it is importan