National Healthcare Scenario , India

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NEW DELHI: Around 27% of India's registered doctors and almost 63% nurses aren't active anymore.

Union health ministry's presentation to the Consultative Committee, which included several MPs, admitted to some worrying trends in human resources in health.

According to joint secretary in the ministry Dr Vishwas Mehta's presentation, the Medical Council of India (MCI) has 7.5 lakh doctors registered under it.

However, Union health ministry's scrutiny has found that two lakh of the registered doctors aren't working anymore. Of the 10.7 lakh nurses registered, six lakh don't exist.

At present, there is only one doctor for every 2,000 population. The target is to have one doctor for every 1,000 population.

While the international nurse to doctor ratio is 3:1, India's count stands at 1.5:1.

Besides, the number of female allopathic doctors (medical graduates with a bachelor's or postgraduate specialist diploma or degree registered with the Indian Medical Council) is abysmally low.

Only 17% of all allopathic doctors and 6% of allopathic doctors in rural areas are women. There is less than one female allopathic doctor per 10,000 population in rural areas (0.5), whereas it is 6.5 in urban areas.

Union health minister Ghulam Nabi Azad informed the Committee that the ministry is giving a special push to nursing education.

"During the last two years, the ministry has sanctioned 132 Auxillary Nurse Midwives (ANM) and 137 General Nursing Midwifery (GNM) schools all over the country. These 269 schools will produce an additional 20,000 nurses every year. Six nursing colleges are also being established at the new AIIMS being set up under the Pradhan Mantri Swasthya Surakhsha Yojana and these will be functional by next year," Azad said.

A skewed distribution of medical colleges is another big problem. The ministry's presentation said 45% of medical colleges are located south India, with 47% of the MBBS seats. North India is home to 17% of the medical colleges, with 16% of the MBBS seats. Western India accounts for 21% of colleges and 22% of the MBBS seats.

In comparison, central India has 5% of medical colleges and 5% of MBBS seats, east has 10% of colleges and only 9% MBBS seats. Northeastern states are most neglected. It has only 3% of medical colleges and 3% MBBS seats.

The Planning Commission recently said geographic and rural-urban imbalance exists in training and availability of human resource. Medical colleges are unevenly spread across the states with wide disparities in the quality of education. Of the 640 districts, only 193 have a medical college.

Azad, however, said that in last three years alone the number of post-graduate seats to produce super specialty doctors has increased by more than 9,100. "The number of PG seats available in this academic year is 22,194 as against 13,043 in the year 2008-09. During 2009-12, 46 new medical colleges have been set up," the minister added.

Under-representation of women in healthcare workforce is seriously affecting women's access to health care. Now, nearly two-thirds or 66% of all health workers are men.

According to the paper "Human Resources for Health in India" published in the British Medical Journal The Lancet recently, one in five dentists are women, while there is one woman in 10 pharmacists.

Against a World Health Organization recommended norm of 23/25 health workers (doctors, nurses, midwives) per 10,000 population, India has 19 health workers per 10,000 (doctors - 6, nurses and midwives - 13).

India has 270 medical schools, from which 28,158 doctors graduate every year.

The southwestern states of Andhra Pradesh, Maharashtra, Karnataka, Kerala, and Tamil Nadu, which together account for 31% of India's population, account for 58% of all medical colleges - both public and private - in the country.

While India faces an acute shortage of trained medical manpower, as many as 1,333 doctors migrated to foreign shores over the...
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