Saturday, August 07, 2010

Acute shortage of doctors, paramedics in India's rural areas

The shortage of doctors and paramedical staff for the country's poor and downtrodden is assuming alarming proportions. According to the latest data on rural health statistics, a huge number of posts sanctioned for medical staff in primary and community health centers have been lying vacant. Consider the case of primary health centres. The vacancies stack up to 5224 doctors, 7243 health care workers and 1701 health assistants, respectively. The situation is equally grim for community health centres. As many as 4026 sanctioned posts for specialists are up for grabs, while that of pharmacists are 5000. Cumulatively, 5591 slots for lab technicians are yet to be filled, and there is a dire need for 10,089 nurses and midwifes. Sub-centers for health are short of 26,208 health workers.

Union health minister Ghulam Nabi Azad maintained that the appointment of doctors and paramedical staff is done by respective state governments. The reasons of shortage may vary from state to state. It could be because of shortage of trained manpower or even less development of basic infrastructure like roads, connectivity and banks, he reasoned. According to the ministry, human resource engagement is a priority issue, and an integral part of the flagship National Rural Health Mission. This includes multi-skilling of doctors and paramedics, provision of incentives, to serve in rural areas like blended payments, difficult areas allowances, PG allowance, case-based payments and improved accommodation arrangements. Provision of Ayush doctors and paramedics in PHCs and CHCs to serve as additional doctors in rural areas are also being looked at. Block pooling of doctors in underserved areas, engaging with the non-government sector for underserved areas are also being worked out, Azad said.

Experts say more than the vacant positions, absconding doctors are a genuine cause for concern. Officials claim though many doctors don't even turn up to treat patients in primiary and community health centres, they continue to draw their salaries on a regular basis.

An earlier ministry report had pointed out while only 6.3% of the posts for doctors are vacant on paper, a staggering 67% of them play truant. To make matter worse, the nation has been facing an acute shortage of doctors for long. As per a Planning Commission study, the country is short of 600,000 doctors,10,00,000 nurses and 200,000 dental surgeons, leading to a dismal doctor-patient ratio. In fact, for every 10,000 Indians, there is only one doctor. Though there is an annual demand for 30,000 specialised doctors, only 12,000 post-graduate students pass out every year.

In a bid to tide over the growing crisis, the ministry is now mulling over the option of curtailing the duration of the undergraduate medical degree to three and a half years. Under the scheme, the Bachelor of Rural Medicine and Surgery (BRMS) degree can be acquired in two phases and at two different levels in community health facility (one-and-a-half-year duration) and sub-divisional hospitals (secondary level hospitals) for a further duration of two years.

Source: The Times of India, August 7, 2010

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