Behavior of health workers toward the implementation of clinical guidelines

Background: The maternal health situation in the country always presents challenges before the overall health system in India. Implementation of clinical guidelines can bring uniformity and standards of treatment protocol, leading to better maternal health outcome. Objectives: To understand the attitude, behavior, and challenges faced by health workers with regard to the implementation of clinical guidelines and protocols in the domain of maternal health. Setting and Design: Different cadres of health care providers working at the district and block levels were selected conveniently with the permission of the State health administration. In addition, nursing and medical academicians were also included in the study. Materials and Methods: A pilot qualitative study in two districts of Assam was carried out. Different cadres of health workers such as Medical Officers (MO), Rural Health Practitioners (RHP), and Nurses working at the district and block levels were interviewed in-depth with the help of a semistructured interview schedule, which lasted for 26 days during May-July 2014. Results: The study elicited several pertinent issues related to the implementation of clinical guidelines, which include the introduction of clinical guidelines as a part of academic training, awareness about clinical guidelines, the commonest conditions for which clinical guidelines are used, challenges faced in accessing and implementing guidelines, and specific areas where clinical guidelines should be developed. Poor penetration of clinical guideline implementation was observed in the domain of maternal health care in the study area. Conclusion: Given the situation of maternal morbidity and mortality, the implementation of clinical guidelines appears rational.