AsianScientist (Jun. 20, 2019) – The skilled health workforce in India does not meet the minimum threshold of 22.8 skilled workers per 10,000 population recommended by the World Health Organization (WHO), according to research published in the online journal BMJ Open.
For healthcare in developing countries to improve, inherent weaknesses across the healthcare value chain need to be addressed. In this study, researchers led by Professor Sanjay Zodpey at the Indian Institute of Public Health, Delhi, India, retrieved data on the number of registered practitioners, such as doctors, nurses, physiotherapists and dentists, from published literature and websites of professional councils and organizations to estimate the state of healthcare in India.
They also estimated the number of qualified and unqualified healthcare workers actually working in India using the 68th round (July 2011-June 2012) of National Sample Survey Organisation (NSSO) data on ‘Employment and Unemployment Situation in India’—a household survey conducted every five years.
They found that in addition to registered practitioners, the health workforce in India includes many informal medical practitioners, such as traditional birth attendants, faith healers, snakebite curers and bonesetters without formal education or training. The total size of health workforce registered with different councils and associations was five million, but the NSSO estimated the size of the workforce to be 1.2 million fewer, at 3.8 million.
Based on the registration data, the density of the total health workforce was estimated to be 38 per 10,000 population, but the NSSO data found it be lower at 29 per 10,000 population. In eastern and rural states, total health workforce density was lower than the WHO minimum threshold of 22.8 per 10,000 population.
The estimates also reveal an alarmingly large presence of unqualified health professionals, said the authors—adjusting for adequate qualifications of health workers reduced the workforce density from 29 to 16 health workers per 10,000 population.
The data also showed that approximately 25 percent of currently working health professionals do not have the required qualifications as laid down by professional councils, and that 20 percent of adequately qualified doctors are not in the current workforce. More than 80 percent of doctors and 70 percent of nurses and midwives were employed in the private sector.
The researchers point to several limitations of their study, including the registration data being inadequately updated and likely to include deceased, unemployed and professionals who have migrated overseas.
Nonetheless, they concluded that “policy should focus on enhancing the quality of health workers and mainstreaming professionally qualified persons into the health workforce.”
The article can be found at: Karan et al. (2019) Size, Composition and Distribution of Human Resource for Health in India: New Estimates Using National Sample Survey and Registry Data.
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Source: BMJ; Photo: Pixabay.
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