Policy & Issues

Plug the yawning gap

The ratio of nurses and midwives in India is 13 per 10,000 persons.  

As the government sets about reforming the public health sector and making universal health coverage a reality in India, the availability of qualified human resources for health (HRH) has emerged as a significant challenge facing the healthcare delivery mechanism.

India faces an acute shortage of over 64 lakh skilled human resource in the health sector with Uttar Pradesh alone accounting for a shortfall of 10 lakh allied healthcare professionals, according to a latest study titled From Paramedics to Allied Health Sciences: landscaping the journey and way forward undertaken by the Public Health Foundation of India for the Ministry of Health and Family Welfare.

There is an urgent need for the government to plug policy gaps and ensure generation of adequate and effective HRH to provide quality care at primary, secondary and tertiary levels of health delivery in the country.

As per the most recent figures reported in the World Health Statistics 2011, the density of doctors in India is six for a population of 10,000, while that of nurses and midwives is 13 per 10,000 persons. India has a doctor to population ratio of 0.5: 1000 in comparison to 0.3 in Thailand, 0.4 in Sri Lanka, 1.6 in China, 5.4 in the U.K., and 5.5 in the U.S.

The HRH shortfall has resulted in the uneven distribution of all cadres of health workers, medical and nursing colleges, nursing and ANM (Auxiliary Nurse and Midwife) schools, and allied health institutions across the States with wide disparity in the quality of education.

The uneven distribution of professional colleges and schools has led to an imbalance both in the production capacity and in the quality of education and training, leading to poor health outcomes. There is ample international evidence suggesting that empowered allied health professionals or paramedics, as they are known at present, can be the leaders of change, playing critical role in improving the reach of health services in underserved areas.

According to the report, there is a gap of 20.42 lakh dental assistance-related technologists, 18.22 lakh rehabilitation-related workforce, 8.93 lakh miscellaneous health workers and 8.58 lakh surgery and anaesthesia-related professionals. There is also a shortage of around 2.36 lakh medical technologists, 1.98 lakh surgical and intervention technology-related health professionals, 1.28 lakh ophthalmology-related workers, 61,670 medical laboratory professionals and over 19,217 radiography and imaging experts.

In 2007, the government had proposed setting up of separate councils for medical laboratory technicians, radiology technicians, and physiotherapists/occupational therapists. These councils would be responsible for the maintenance of uniform standards of education in the respective disciplines and the registration of qualified personnel to practice the profession.

Among States having the widest gaps in health manpower, Maharashtra ranks second with 5.65 lakh less paramedics and Bihar third with 5.28 lakh paramedics required. While West Bengal has 4.62 lakh less health workforce, there is a shortage of 4.22 lakh health professionals in Andhra Pradesh and 3.68 lakh less allied health professionals in Tamil Nadu.

Calling for regulating allied health professional courses in India, the survey studied over 1,000 institutions and carried out literature review which revealed a plethora of institutions across the country offered a wide variety of courses varying in quality and output on allied subjects.

The lack of planned courses and institutions, non-uniform nomenclature for the existing courses, diverse standards of practice and lack of qualified faculty pose a threat to the quality of education and skills of the allied health professionals. Thus there is a need to standardise the course duration, curricula, training methodologies and other such components pertaining to the education and training of allied health professionals.

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Printable version | May 3, 2021 3:11:19 PM | https://www.thehindu.com/sci-tech/health/policy-and-issues/plug-the-yawning-gap/article4249369.ece

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