title: Experience of using mHealth to link village doctors with physicians: lessons from Chakaria, Bangladesh.
abstract: BACKGROUND
  Bangladesh is facing serious shortage of trained health professionals. In the pluralistic healthcare system of Bangladesh, formal health care providers constitute only 5 % of the total workforce; the rest are informal health care providers. Information Communication Technologies (ICTs) are increasingly seen as a powerful tool for linking the community with formal healthcare providers. Our study assesses an intervention that linked village doctors (a cadre of informal health care providers practising modern medicine) to formal doctors through call centres from the perspective of the village doctors who participated in the intervention.
  
  
  METHODS
  The study was conducted in Chakaria, a remote rural area in south-eastern Bangladesh during April-May 2013. Twelve village doctors were selected purposively from a pool of 55 village doctors who participated in the mobile health (mHealth) intervention. In depth interviews were conducted to collect data. The data were manually analysed using themes that emerged.
  
  
  RESULTS
  The village doctors talked about both business benefits (access to formal doctors, getting support for decision making, and being entitled to call trained doctors) and personal benefits (both financial and non-financial). Some of the major barriers mentioned were technical problems related to accessing the call centre, charging consultation fees, and unfamiliarity with the call centre physicians.
  
  
  CONCLUSIONS
  Village doctors saw many benefits to having a business relationship with the trained doctors that the mHealth intervention provided. mHealth through call centres has the potential to ensure consultation services to populations through existing informal healthcare providers in settings with a shortage of qualified healthcare providers.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. nazib@icddrb.org.
authors.forename: Nazib Uz Zaman
authors.initials: NUZ
authors.lastname: Khan
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Rasheed
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Tamanna
authors.initials: T
authors.lastname: Sharmin
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.|Institute of Development Studies (IDS), University of Sussex, Library Road, Brighton, BN1 9RE, UK.
authors.forename: Tanvir
authors.initials: T
authors.lastname: Ahmed
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Shehrin Shaila
authors.initials: SS
authors.lastname: Mahmood
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.|School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW, 2052, Australia.
authors.forename: Fatema
authors.initials: F
authors.lastname: Khatun
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Sma
authors.initials: S
authors.lastname: Hanifi
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Shahidul
authors.initials: S
authors.lastname: Hoque
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Iqbal
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Abbas
authors.initials: A
authors.lastname: Bhuiya
mesh_terms: D000328:Adult; D000368:Aged; D001459:Bangladesh; D003153:Community Health Services / Q000458:organization & administration*; D003150:Community Health Workers; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D012017:Referral and Consultation / Q000458:organization & administration*; D012424:Rural Population; D017216:Telemedicine / Q000379:methods*