In a jaw dropping disclosure made regarding the healthcare workforce of the country, a recently published report by the World Health organisation has stated that 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.
The report which is based on the census data of 2001 has revealed even poorer figures for the rural areas where just 18.8 per cent of allopathic doctors had a medical qualification.
Some of the salient disclosures made by the study include
- At the national level, the density of all doctors (allopathic, ayurvedic, homeopathic and unani) was 79.7 doctors per lakh population, and of nurses and midwives 61.3 per lakh population. The comparable figures for China in 2005 were 130 for doctors, and 96 for nurses, per lakh population. In both countries, the densities were higher in urban than in rural areas, but in India the urban density of doctors was 4 times higher than in rural areas, whereas in China it was only twice as high as in rural areas. In short, India had significantly fewer doctors per person compared to China, and their distribution between urban and rural areas was much more unequal.
- Many individuals claiming to be doctors in India do not have the requisite professional qualifications. Almost one third (31.4%) of those who called themselves allopathic doctors in 2001 were educated up to only secondary school level, and as many as 57.3% did not have a medical qualification. Expectedly, lack of medical qualification is disproportionately concentrated in rural areas. Whereas 58.4% of allopathic doctors in urban areas had a medical qualification, only 18.8% of those in rural areas had such a qualification.
- Of all health workers 38.0% were female, but of allopathic doctors only 16.8% were female. Female health workers were more educated and medically qualified than male health workers in every category (except ancillary health professionals). For example, in the category of allopathic doctors, 86.3% of females compared to 65.0% of males had more than secondary schooling, and 67.2% of females compared to 37.7% of males had a medical qualification.
- Significant variations in the concentration of allopathic doctors and of nurses are observed. In Uttar Pradesh, the concentration of nurses (6.35%) was less than half the share of the state in the national population,i.e. the state’s population concentration (16.16%). In Maharashtra, the concentration both of allopathic doctors (12.01%) and of nurses (15.81%) was substantially higher than the state’s population concentration (9.42%). Orissa had a significantly high concentration of nurses (6.17%) relative to its population share (3.58%), but a low concentration of allopathic doctors (1.54%). Kerala had a significantly higher concentration of nurses (9.36%) than its population share (3.10%), and a concentration of allopathic doctors (3.09%) that was similar to its population share.
- Among allopathic doctors, the percentage with a medical qualification nationally was 42.7%. This percentage was lowest in Uttar Pradesh (18.4%), Bihar (25.9%) and Uttarakhand (26.5%) . In 12 states, including six northern states, the majority of allopathic doctors did not have a medical qualification.
- Among dental practitioners, the percentage with a medical qualification nationally was 42.3%, similar to that among allopathic doctors. In 21 states, the majority of dental practitioners did not have a medical qualification.The national density of dentists was extremely low at 2.4 per lakh population, which was made even worse by the severe maldistribution of dentists across districts. Of 593 districts in the country, 58 districts had no dentists at all; 88 districts had no dentists with more than secondary schooling; and 175 districts had no dentists with a medical qualifications
The data described in this study are for the year 2001 and the situation should have improved over the past decade and a half. But the lack of qualified human resources, especially in rural areas, constitutes a major constraint in India’s ability to improve health outcomes. To advance health outcomes, India needs to step up the capacity to produce and deploy medically trained personnel rapidly – in both rural and urban areas.