Cultural and monetary factors play a big role here

The jury on who is a quack and what qualifies as quackery is still out. Be that as it may, informal healthcare providers, as public health experts call them, are more often than not the first point of contact for treatment for a vast majority of the population.

In fact, Upendra Bhojani, faculty member from the Institute of Public Health (IPH), said that these informal healthcare providers account for almost half the total number of healthcare providers in India.

Affordability is crucial

But why do people choose the informal system over the formal? Affordability, says Mr. Bhojani.

Quoting from a sample survey IPH conducted in the city’s Kadugondanahalli (KG Halli) area in 2009-10, covering 9,299 households (44,500 people) to ascertain the role out-of-pocket (OOP) payments on healthcare play in the lives of the urban poor, he said 3.1 per cent of those suffering from chronic illnesses did not seek treatment.

Some of the patients who opted for treatment on their own reduced the dosage to make the medicine last longer.

Apart from financial constraints, public health expert Ravi Narayan cited the time informal health providers give to their patients, as opposed to the qualified ‘formal’ doctors.

Familiarity

“The informal providers are often from the same area and know the patients and their history well.

“The government hospital system is often overburdened and doctors can’t give patients enough time.

“There is also documented proof that the informal providers charge less,” he said.

Drawing from the experience in KG Halli, he said that the government and corporation hospitals in the locality were closed in the evening, forcing people to go to other hospitals.

Though there is no clear trend as to what ailments people go to quacks for, social stigma attached to sexual diseases prompt them to go to the informal centres, said the experts.

“As we don’t have enough sex education in our schools and colleges, many end up going to these people instead of teachers and doctors,” explained Dr. Narayan.

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