The behaviour of health care providers in managing diarrheal disease in Palembang City South Sumatera Indonesia.

In late 1989 and early 1990 researchers conducted a knowledge attitude and practice study of health care providers in Palembang City Indonesia to determine the behavior of health care providers in managing diarrheal disease (DD) cases. Overall health care provides knew accepted and practiced oral rehydration therapy (ORT) but they still considered antibiotics as a major method to manage DD. Even though they tended to avoid using antimotility drugs some continued to prescribe loperamide. This could be due to a campaign by manufacturers and some reports on benefits and safety of loperamide use in DD. Health care providers tended to advise continued appropriate feeding during diarrhea. This finding surprised many who assumed that most providers semistarved DD cases. Most health care providers felt that medical and nursing schools did not train and motivate them well enough to do health education on a community basis. They did provide health education on a physician-patient basis however. Since health care providers were motivated to preserve and elevate their self image they did not fully implement the concept and knowledge that the Indonesian Diarrheal Diseases Control Program (CDD) had promoted. Even though the CDD induced health care providers to accept ORT avoidance of antimotility drugs and appropriate feeding health care providers reached the behavior frozen state. Thus public health professionals needed to remotivate them to induce more change. They should use scientific reasoning to promote behavior change such as stressing the importance of nutrient sufficiency during diarrheal diseases. They can convince identification figures (more senior well positioned providers) to accept new behaviors. Lastly they can apply social pressure on health care providers via the mass media.