Public health

Shortfall in skilled health workforce

Print edition : June 21, 2019

The skilled health workforce in India does not meet the minimum threshold of 22.8 skilled workers per 10,000 population recommended by the World Health Organisation (WHO), according to a recent study by A. Karan and associates of the Indian Institute of Public Health, Delhi (IIPH-D). The research has been published in the online journal “BMJ Open”.

The present study used data from the number of registered practitioners, such as doctors, nurses, physiotherapists and dentists, from published literature and websites of professional councils and organisations; and the 68th round (July 2011-June 2012) of the National Sample Survey Office (NSSO) on “Employment and Unemployment Situation in India”.

Besides registered practitioners, the health workforce in India includes many informal medical practitioners, such as traditional birth attendants, faith healers, snakebite curers and bonesetters without formal education or training. The total size of the health workforce registered with different councils and associations was 5 million, but the NSSO estimate was 3.8 m, 1.2 m less, as of January 2016.

Based on the registration data, the density of the total health workforce was estimated to be 38 per 10,000 population, but the NSSO data found it to be lower at 29 per 10,000 population. In eastern and rural states, the total health workforce density was lower than the WHO minimum threshold of 22.8 per 10,000 population. According to the registry data, the density of doctors and nurses and midwives per 10,000 population across India was 26.7, whereas the NSSO data put it at 20.6.

The Global Health Workforce Alliance and WHO have categorised India among the 57 most severe crisis-facing countries in terms of availability of health workforce.

According to the study, about 25 per cent of working health professionals do not have the necessary qualifications as laid down by professional councils, and that 20 per cent of adequately qualified doctors are not in the current workforce. More than 80 per cent of doctors and 70 per cent of nurses and midwives were employed in the private sector. The authors conclude: “Distribution and qualification of health professionals are serious problems in India when compared with the overall size of the health workers.”