Almost one-third (31 per cent) of those who claimed to be allopathic doctors in 2001 were educated only up to the secondary school level and 57 per cent did not have any medical qualification, a recent WHO report found, ringing the alarm bells on India’s healthcare workforce.
The situation was far worse in rural India, where just 18.8 per cent of allopathic doctors had a medical qualification, the study titled ‘The Health Workforce in India’, published in June 2016, revealed.
Speaking to The Hindu , Dr. Reena Nayyar, Secretary of the Medical Council of India (MCI), said, “I don’t think this report has officially come to the MCI yet. But in general, any person practising allopathic medicine who does not have a registered medical qualification comes under quackery.”
Interestingly, female healthcare workers – 38 per cent of the total – were found to be more educated and medically qualified than their male counterparts.
For instance, among allopathic doctors, 67 per cent of females had a medical qualification compared to 38 per cent of males.
The data for each district in the country from the 2001 census were specially extracted for this study, which provided a comprehensive picture of health workers in each district.
Researchers hoped that a similar study was repeated with data from Census 2011, which was not yet available.
The study revealed that the density of all doctors — allopathic, ayurvedic, homoeopathic and unani — at the national level was 80 doctors per lakh population compared to 130 in China.
Ignoring those who don’t have a medical qualification, the number for India fell to 36 doctors per lakh population. As for nurses and midwives, India had 61 workers per lakh population compared to 96 in China. The number reduced tenfold to 6 per lakh population, if only those with a medical qualification were considered.
The study found substantial variation in the density of health workers across States and districts. For instance, Kerala had 38.4 per cent of the country’s medically qualified nurses but constituted only 3.1 per cent of the total population. Similarly, West Bengal had 30.6 per cent of all homoeopathic doctors in the country but only 7.8% of the population. Better-off States seemed to afford more doctors plus nurses per capita, the study noted.
District-wise, the inequalities were massive. The density of allopathic doctors with any level of education in the lowest 30 districts — half of which were in north-eastern States and the other in central States — was a little over 9.4 per lakh of the population whereas, in the highest 30 districts, it was 159 per lakh of population, it said.
In the case of dentists, the situation was even worse. The national density of dentists was extremely low at 2.4 per lakh population, with 58 (of the total 593) districts having no dentists at all in 2001. In fact, 175 districts (30 per cent) had no dentists with a medical qualification.
“The proposed study would provide an extremely valuable benchmark even if only for 2001,” Montek Singh Ahluwalia, former Deputy Chairman of the Planning Commission (now NITI Aayog) noted in the preface to the report. While presenting this study to the then PM Manmohan Singh, he mentioned that all doctors did not need to have an MBBS degree.
“In the period between 2005 and 2009, there was a major expansion of both public education in medical, nursing and allied schools in most States, by as much as 500 per cent in some cases. So the situation would have changed dramatically. There was also a private expansion,” said T. Sundararaman, Dean of the School of Health Systems at the Tata Institute of Social Sciences.
There have been no attempts on the part of the government to curb quackery, said Dr. A.V. Jayakrishnan, Chairman of the Standing Committee on Anti-Quackery set up by the Indian Medical Association.
“It is a well-known fact that in many States, quacks are operating in large numbers. Laws are so weak that even if the frauds are caught, they get bail on the following day and start practising again,” he told The Hindu .