The Central government’s plan to create a specialised cadre of health care workers for rural areas has hit a roadblock.
The Indian Medical Association – the country’s largest non-government organisation for allopathic doctors – has opposed the move fearing that the Health Ministry will “create two tiers of medical professionals”.
The IMA has written to the Central government strongly objecting to the introduction of the course.
An estimated 600 million people in India, many of them in rural locations, have little or no access to health care. The Union Health Ministry has brought in a plan to create a “specialised cadre of health care workers for rural areas” by instituting a three-year-course -- Bachelor of Science in Community Health -- in State universities.
Already approved by the Union Cabinet and all-set to be implemented, the creation of this cadre of community health officers -- to be posted at sub-centres functioning under the Ministry of Health and Family Welfare – will facilitate basic health care for rural population. Speaking to The Hindu , IMA national president Dr. A. Marthanda Pillai said, “Sub-centres are the cornerstones of disease prevention activities and implementation of national health programmes and not primarily meant to provide curative service except home remedies.”
He said the staff pattern in the sub-centre consists of one male and one female multipurpose health worker. The job description of these staff is family welfare services, immunisation, awareness, household visits, data collection regarding disease prevalence, and coordinating other national disease control programmes.
“These staff currently work under the supervision of a medical officer posted at primary health centres. For this purpose there is no need for a more qualified workforce. Posting the proposed B.Sc (Community Heath) graduates in sub-centres will be a wrong human resource management,” he said.
Students opting for B.Sc (Community Heath) course will study basic anatomy, and diagnosis and treatment of basic ailments.
The emphasis of training will be on conducting normal deliveries, pre-and anti-natal care, handling diarrhoea, pneumonia, vaccination, providing tuberculosis treatment and treatment of fevers and skin infections.
Doctors, however, claim that at sub-centre level a more suitable workforce would be an Accredited Social Health Activist worker with basic primary education and training.
“The policy proposal on this is not based on ground reality and is conceptually wrong,” said an IMA official.
The Association has also said that entrusting newly proposed BSc (community health) graduates to manage very sensitive areas like child health may even worsen the situation.
“To leave the health of children and adolescents in the hands of ill-equipped personnel is detrimental and may nullify the results of years of hard work that the country has put into reducing child mortality and morbidity,” they warned.
Meanwhile, the National Board of Examination (NBE) has already prepared the curriculum for the course which will be sent to the State universities.
