Shortage of specialist doctors: 9268 posts lying vacant at Community Health centres

New Delhi: There is a shortage of around 68% specialist doctors like surgeons, pediatricians, obstetricians and gynecologists and physicians in rural India, stated the new rural health report of the centre. The percentage shows the skewed nature of healthcare services available at thousands of community healthcare centres (CHC) in the rural areas. 

As per a media report in the Deccan Herald, India needs around 22,000 specialist doctors for its more than 5,000 CHC's in rural areas. However, the total number of sanctioned posts in reality are 13,637 of which 9,268 positions are vacant. 

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There are around 945 sanctioned posts in Madhya Pradesh, out of which 902 are vacant whereas 730 posts were vacant in Bihar out of 836 sanctioned posts. 498 out of 684 positions have not been filled up in Jharkhand, in Odisha more than 1,200 sanctioned posts out of 1511 are vacant. 

Karnataka and Telangana have more than 50% vacancy in the sanctioned posts of specialist doctors in the CHCs, whereas in Andhra Pradesh and Tamil Nadu, the situation is slightly better with 32% and 23% vacancy. Kerala is the only state with no such vacancy. 

The report states that the posts of 72.3% of surgeons, 64% of obstetricians and gynaecologists, 69% of physicians and 67.1% of pediatricians are vacant out of the sanctioned posts, as of March 31, 2021. 

T Sundararaman, former executive director of the National Health Systems Resource Centre said, "Lack of specialists is a genuine problem in many states due to an international transition of doctors to corporate hospitals,"

The situation has deteriorated over the last few years as in 2005, the shortage of specialists stood at 46% which has now gone upto 68%. The situation hasn't changed much in the last two years. 

Dileep Mavlankar, director, Indian Institute of Public Health, Gandhinagar told the Deccan Herald, "For the government, the primary or secondary care at rural CHCs is not the priority. Also, there is hardly any push from agencies like WHO or UNICEF. But if there is a dedicated manager at the health ministry and the government is serious, then there are models to improve the CHCs."

According to experts, the government failed to provide enough resources into CHCs and did not look for innovative approaches to lure and retain specialists in villages. T Sundararaman added, "Students who pay huge capitation fees in private medical colleges, would not join government service after passing out. They would not be able to pay their loans if they work for the government. They would look for ways to recover the money."

There is a huge shortage of radiographers, nursing staff and laboratory technicians. For example, Bihar has no radiographer in rural areas while Gujarat has eight.

Further, the CHCs in 37 states and Union Territories have more than 1.06 lakh sanctioned posts of nurses of which close to 30,000 are empty, which is a shortfall of 28%. The gap is significantly visible in the states of Bihar (68%), Odisha (49%), Uttar Pradesh (42%), Haryana (29%) and West Bengal (22%). 

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