The real deficit in India’s health care system

To accelerate the pace and meet our global health commitments, India must build more institutions for producing professionals and create a conducive environment, with adequate pay packages, to attract and retain the best talent in the workforce.

A new report by the World Health Organization (WHO) and the Public Health Foundation of India (PHFI) has revealed that India’s health system struggled during Covid-19 because the country doesn’t have an adequate number of trained health personnel. For example, the nurse-doctor ratio is 1.7:1, and that of allied health workers to doctors is 1:1 India’s High-Level Expert Group (HLEG) on Universal Health Coverage recommends a nurse-doctor ratio of 3:1. Other than the lack of an adequate number of health workers, there is also a considerable variation in the number of health personnel available across states and the rural and urban areas.

India’s High-Level Expert Group (HLEG) on Universal Health Coverage recommends a nurse-doctor ratio of 3:1. Other than the lack of an adequate number of health workers, there is also considerable variation in the number of health personnel available across states and the rural and urban areas. (HT PHOTO)

The State’s focus has been on building physical infrastructure and buying equipment. To be sure, Prime Minister Narendra Modi has spoken of the need for health workers at all levels, but this will take time to translate into reality. The second problem is the focus on tertiary care instead of primary and secondary health care centres, and a focus on the number of specialised health care professionals when India also needs frontline medical professionals. Third, India produces only 13 new medical graduates (doctors and nurses) per annum per 100,000 persons, compared with more than 55 medical graduates in developed countries. More than 30% of the doctors and 50% of the nurses are not part of the current workforce. The government is setting up 157 new medical colleges and 50 nursing institutions, likely to produce about 22,500 doctors and 2,000 nurses every year. This essentially implies, a PHFI calculation shows, that even if 100% of the new graduates join the health workforce, it will take more than 10 years to add 250,000 health professionals to the existing health workforce size of about 170,000.

To accelerate the pace and meet our global health commitments, India must build more institutions for producing professionals and create a conducive environment, with adequate pay packages, to attract and retain the best talent in the workforce.