Exploring the Attitudes and Perceptions of Assistant and Registered Medical Officers Toward their Role in Health Care Delivery in Sri Lanka

Abstract

The Assistant and Registered Medical Officers (AMO/RMOs) of Sri Lanka have held a major role in health care delivery, particularly in rural areas. The Sri Lankan government decided to discontinue the AMO training program in 1995 and to phase out the profession completely, without conducting any research on what the impact of this policy decision may be. Fifteen semi-structured interviews were conducted with a purposeful sample of practicing AMO/RMOs from May to July 2012 to gain qualitative preliminary data on how the AMO/RMO profession is viewed by those who work within it. Interviews were conducted primarily in English, with simultaneous translation into Sinhala by a research assistant where necessary. Interview transcripts were reviewed for repeated words and phrases, and overarching themes were drawn from these textual patterns. Analysis of the transcribed interviews yielded themes regarding lack of educational and promotional opportunity, similarities and differences between RMOs and Medical Officers (MOs), barriers to quality of care, gaps in supervision, level of job satisfaction, the nature of working relationships with other health professions, and predictions about the future of the AMO/RMO profession. This preliminary and exploratory data can be used to inform more comprehensive and objective research on the role and impact of AMO/RMOs in the future. It can also inform policy decisions and recommendations regarding health workforce composition and shortage, task-shifting, and use of mid-level providers.