How Chhattisgarh got doctors to work in areas worst hit by Maoists
While most states are struggling to retain doctors to work in rural areas, the Left-wing Extremism (LWE)-affected Chhattisgarh has shown how. It has managed to retain doctors by offering them high salaries, opportunity for career advancement, and facilities to work in Maoist-hit districtsopinion Updated: Jul 05, 2017 12:59 IST
Karnataka is inviting doctors to bid online how much they want to be paid to fill 1,035 vacancies for specialists in government hospitals in rural areas. “Despite being offered salaries of Rs 1.25 lakh, specialist doctors are not willing to work in government hospitals, so we are asking them to suggest how much they want, and they will be appointed if their bids are approved,” said state health minister Ramesh Kumar.
India doesn’t have enough doctors to treat its sick and ailing, with the shortage of doctors being far worse in rural India, which is home to 60% of the country’s 1.3 billion population.
There is one allopathic doctor per 11,097 population, shows data from the National Health Profile 2017, when the World Health Organisation’s recommended ratio is 1/1,000 population. The ratio is far lower in rural areas that have just 11,054 hospitals for more than 700 million people.
While most states are struggling to retain doctors to work in rural areas, the Left-wing Extremism (LWE)-affected Chhattisgarh has shown how. It has managed to retain doctors by offering them high salaries, opportunity for career advancement, and facilities to work in districts where LWE has claimed 108 lives since January.
Under a project that started in two districts in partnership with the Public Health Foundation of India in 2015, the state has attracted specialists – gynaecologist-obstetricians, general surgeons, paedict surgeons among others – from Maharashtra, Andhra, Telangana and Uttar Pradesh to live and work in these two districts where there are mine-clearing vehicles and CRPF camps every 5 km of NH-43, but no private hospitals or clinics.
This has been done by giving more autonomy to district collectors in the use of flexi-funds from the National Health Mission (NHM) and district mineral foundation (DMF) to offer specialists salaries that are two to three times higher than what they would earn in an urban hospital. Specialists earn between Rs 2 and Rs 2.5 lakh a month. A senior paediatric and general surgeon, for example, was offered Rs 2.6 lakh – Rs 1.59 lakh from NHM and Rs 1.1 lakh from DMF.
Money apart, doctors and their families are being given the same facilities as civil servants and army personnel, including homes and incentives for career advancement, such as three marks per year for PG and priority in training programmes overseas. Social support in the form of help with their children’s school admission and jobs for their spouses, depending on their qualifications, is also provided.
So successful has the experiment been that the Chhattisgarh government has branded the project as the Chief Minister’s Fellowship Programme and expanded it from three to 10 districts this year.
The learning from this LWE-affected state is that with facilities and incentives, doctors can serve in the grimmest of conditions.