According to a recent study published in the Science Journal in February 2024, misperceptions among healthcare providers are identified as a significant barrier to prescribing Oral Rehydration Solution (ORS) for children suffering from diarrhoea in India. The study, titled ‘What drives poor quality of care for child diarrhoea? Experimental evidence from India’, conducted across 253 medium-sized towns in Karnataka and Bihar, aimed to explore the reasons behind the underprescription of ORS in the country.
Led by Arnab Mukherji, chairperson of the Post Graduate Programme in Public Policy and Management at the Indian Institute of Management – Bangalore (IIMB), the study involved researchers from various institutions including the Pardee RAND Graduate School, Sanford School of Public Policy at Duke University, and the University of Southern California in the USA.
The study, conducted in 2023, surveyed over 2,000 private healthcare providers, ranging from single doctor clinics to nursing homes, as well as 25 standardised patients trained to present as caretakers of children with diarrhoea. Through randomised controlled trials, the researchers examined the impact of three main factors – misperception of providers, financial incentives, and ORS stock availability – on the underprescription of ORS.
Misperceptions among healthcare providers accounted for 42% of underprescription, arising from confusion regarding patient preferences for non-ORS treatments, the taste of ORS, and its perception as not being genuine medicine. However, when standardised patients expressed a preference for ORS, prescriptions increased significantly by 27 percentage points.
Financial incentives for prescribing alternative treatments were perceived as a barrier by 5% of providers, but eliminating these incentives did not affect ORS prescription rates. Similarly, ORS stock availability was identified as a barrier by only 6% of providers, with the provision of a six-week supply resulting in a notable increase in ORS provision.
In light of these findings, the researchers recommend interventions focused on improving provider perception and encouraging patients to express their treatment preferences during consultations. By addressing misperceptions and promoting patient involvement in decision-making, efforts can be made to enhance the prescription of ORS, a life-saving treatment for child diarrhoea in India.
