Table 2 Types of health providers by perceptions of main services provided
From: Coping with uncertainty during healthcare-seeking in Lao PDR
Provider | Provider in Lao | Main perceptions by FGD participant | Position in the health system |
|---|---|---|---|
Village health volunteer | Aa saa sa mak saa tha la na souk ban (aw saw saw baw) | Selling a limited number of medicines. Knowing a limited number of sicknesses. | Trained by MOH. Member in the Village Authority Committee |
Trained birth attendant | Pha doung khan | Prenatal advice and assistance during home delivery. | Trained by MOH. Member of Village Authority Committee. |
Traditional birth attendant | Moh tam Nyae | Helps during complicated births, changing the position of the baby during pregnancy. | Existed before the expansion of primary healthcare. |
Herbalist | Moh Ya | Produces, sells and treats with herbs most often found in the local forests. | Active both among Buddhists and animists. Recognized as a traditional provider by the MOH |
Diviner | Moh Phi | Divination (communication with ancestral and nature spirits) as tool to identify cause of illness and treatment. Can determine if illness has a spiritual cause or not. Can only treat illnesses with spiritual cause. | Most popular among animist groups. Not considered integral to the formal healthcare system |
Fortune-teller | Moh duo | Divination (communication with Buddha to identify cause of illness). The fortune-teller will organize the ceremony /treatment in the room with the Buddha image, plate of candles and flowers (set up the room like temple). Uses birth dates, times and Chinese horoscope to identify cause of illness. | Most popular among Buddhist clients. Not considered integral to the formal healthcare system |
Nurse (retired, military trained or after formal work hours) | Thaan moh (Phaed khao, Phaed tha haan lou phaed noak mhong kaan) | Can diagnose, provide treatment and sell medicine. Have few medical instruments such as stethoscope. | Most frequently trained in the military and also can offer mobile services. Some of these nurses are also civil servants working at the health center or district hospital; but the most common is that they have retired from the civil service or the military. This is extra income for the nurses. |
Mobile drug vendor | Moh ya kheuan ti | Known for selling strong and effective medicines. They normally only sell medicines and offer treatments of for example joint pain. | Often they will live in the same district or same village and travel to nearby villages on a regular basis. Will often offer his services from the small retail shop in the village. Only encountered male drug vendors. Have some type of medical background as a VHV or the military. This is their main business. |
Mobile Chinese/Vietnamese drug vendor | Moh ya chin kheuan ti | Known for selling strong and effective medicines. Most frequently active close to border areas. | Will visit village by village in the same province. Often travel by motorbike and can reach remote areas. Sometimes they sell other products like cooking pots. Often arrives after the harvest period. |
Nurse at health center | Phaed souk saa laa | Few medical types of equipment available and few diagnostic procedures performed. Uncertainty whether nurses are able to diagnose more diseases if they have the instruments; or if the MOH did not provide them with more tools due to their limited training or experience. Limited number of drugs for sale. | There is now only one training level of nurses (3 years of training). Earlier a nursing diploma was achieved after 1–2 years of training. |
Nurse and doctor at district level hospital | Pha Nyaa baan lae thaan moh hong moh meuang | Varied number and quality of diagnostic procedures, type of equipment and treatments of illness. | Â |
Nurse and doctor at provincial, central, military hospital | Pha Nyaa baan lae than moh hong moh kheang | Broad access to diagnostic equipment and treatments including surgery. Good quality of care | Â |
Private pharmacist or staff in pharmacy | Haan khay ya aek ka sonh lue paed yu haan khay ya | Selling medicines based on description of symptoms, prescriptions or sometimes measurements. | Owned by a medical doctor or pharmacist. In the rural areas there are class 3 pharmacies that sell drugs from the market place or in front of the hospital. Majority have permanent premises from which they sell medicines. |
Private clinic | Kri nik aek ka sonh | Broad range of diagnostic equipment, strong medicine and well performing health staff. | Â |
Private hospital in Thailand or Vietnam | Hong moh aek ka sonh thai lue hong moh aek ka sonh viet nam | Full range of diagnostic equipment, treatments and professional and qualified health staff | Â |