It is not unusual to find Primary Health Centres (PHCs) in villages closed for long hours, with the patients waiting for a doctor. The reason: many doctors are reluctant to serve in rural areas. Thus, the promised public healthcare to all finds little meaning for the patients in villages, who are left with no option but to go to nearby cities and towns and shell out more money. Availability of emergency services to save lives in these sub-centres is still a dream.
What compounds the problem is the typical demand-supply gap arising out of non-availability of medical and paramedical staff, diagnostic services and medicines. The shortage of doctors is staggering – experts put the figure at six lakh.
With this late realisation, the Union Health Ministry, backed by the Planning Commission, has proposed to introduce a three-and-a-half year Bachelor of Science (Community Health) course to create mid-level health professionals to bridge this gap in the rural areas. On completion of their course, these graduates, who would be equipped with the necessary public health and ambulatory-care competencies, would be deployed at such health centres.
The Centre has already constituted a task force to frame the norms for providing infrastructure in the proposed 'Rural Health Schools' and examine various aspects on form and content of the course. This course is to be introduced from the academic year 2013-14 in medical colleges if the States are willing to adopt it.
The duration of the course will be three years with six months of rotational internship. The eligibility is 10 +2 with science subjects i.e. Physics, Chemistry and Biology. After acquiring this degree, the graduates will be employed as Community Health Officers (CHOs) by State Governments.
According to V.D. Patil, Registrar of KLE University, Belgaum, the aim of the course is to generate a cadre of healthcare providers who are well trained and supported, and motivated to stay put in villages and extend comprehensive healthcare to the needy patients at health sub-centres.
Though the proposal got clearance from the Medical Council of India (MCI), a few associations like the Indian Medial Association (IMA) came out with some critical observations. However, the Government is committed to introducing the course with in-built safeguards to address the issue of acute shortage of trained health professionals/human resources in the rural healthcare sector.
In view of the positions taken by various medical organisations, a threadbare debate to understand the implementation of the proposal had been necessitated. In Karnataka, this task has been assigned to the Karnataka Health Systems Commission (KHSC), which conducted a State-level workshop on 'Right to health and creating new cadre of doctors for primary/basic healthcare' hosted by KLEU in Belgaum recently.
The session, after a day-long deliberations involving academicians, medical education experts and teachers, recommended to the State Government to name the proposed course as 'Diploma in Community Medicine and Surgery' and implement it from 2013-14. Another recommendation suggested that all such diploma holders serve in rural areas for at least five years so that they would become eligible for lateral entry into a two-year programme to obtain a MBBS degree. Thereafter, they would also be eligible to pursue speciality and super-speciality courses in medicine and surgery.
