OBJECTIVES:
To show the big picture of human resource in health of India;
To understand the different health workforce existing in India ;
To assess the extent of imbalances in the distribution of the density of health workforce within India and with different countries; To assess the contribution of health workforce in influencing the health status of the population;
Human resources actually engaged in the health system can be referred to as the health system workforce or health workforce
THE BIG PICTURE OF HUMAN RESOURCES IN HEALTH In the post independent period, India witnessed rapid strides in professionalization of medicine, popularly known as Allopathy Dentistry Ayurveda, Unani, Siddha and Homeopathic medicine (AYUSH) Nurses and Paramedical Staffs Non formal workers
1. ALLOPATHIC DOCTORS
There were allopathic medical practitioners practicing in the different states in India and registered with the different State Councils. 662646
Source: Medical Council of India,2006.
Alongside, as on 31st Dec 2006, Dental surgeons were registered with different State Dental Councils. 72496
Source: Medical Council of India,2006.
100000
80000
60000
40000
20000
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STATES
REGISTERED DOCTORS REGISTERED DENTISTS
M AH
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1600
1598
1598
1598
1598
1598
1598
1598
1400
1200
1000 953 861 800 714 600 471 400 250 200 354 250 250 250 250 250 250 754
Number of allopathic doctors possessing recognized medical qualifications (under IMC act) and registered with state medical councils for the years 2006 and 2007 were 682646 and 696747, respectively.
Number of Dental Surgeon Registered with Dental Council of India in 2006 were 72497.
There are increases in availability of Allopathic Medical Practicioners, Dental Surgeon and Nurses per Lakh Population over the years.
10000000 1364000 682646 251889 133641 58729 90510 66583 18265 6452 72497 116298 136520
1000000
730801 463663
100000
10000
10479 1245
1000
100
10
1 USA 15.30% UK 8.40% JAPAN 7.90% CANADA 10% 4.90% 2% 0.01 4.20% 4.50% INDIA PAKISTAN SRILANKA CHINA
0.1
2.8
(source:indiaonline.in)
678, 17% 1201, 30% SURGEON OBS & GYN PHYSICIAN PAEDIATRICIAN
884, 22%
1215, 31%
MEDICAL CONSULTANTS
80% 70% 60% 75%
PERCENTAGE
50% 40% 30% 20% 10% 0% URBAN SEMI URBAN RURAL 2% 23%
DOCTORS
(source:indiaonline.in)
Service delivery for dental health, mental health, orthopaedics, vascular and cancer diseases 75%
40% of services for communicable diseases and deliveries were being provided by the private sector. In a study of Ujjain district in M.P. 88% qualified doctors were in urban areas and 72% were practicing in Ujjain city itself (Deshpande et al,2004).
2300
There was a much higher density of qualified providers in urban areas (1:2300) than in rural areas (1:26,860).
(Source:WHO Survey 2006)
Source: for 1981 statistics: GOI, CBHI, Health Statistics in India 1981. for 2006 Compiled from www.mciindia.org
10
15
20
25
30
35
40
45
0
A. P AS SA M BI HA GU R JR AT HA RY AN HI A M A CH AL KA RN AT A KA EL A KE R M AH A .P . SH TR A OR RI SA PU RA NJ JA AB S TA TH AN M IL N AD U W ES U. T P. BE N GA L RA M J& K
STATES
DE L PO H GO I
IN 1980-81 IN 2006
ND A IC H ER Y
7. THE DRUG DISPENSERS PHARMACISTS Pharmacist registered with council- 6.8 lakh Pharmacists in the rural PHCs- 3% Community pharmacists- 55% Hospital pharmacists- 20%
Source: Column1: Pharmacy Council of India. Accessed from www. Indiastat. com Columns 2: GOI, Bulletin on Rural Health Statistics in India, 2006
Source: Bulletin on Rural Health Statistics in India 2006- Special Revised Edition, MOHFW
Overall about 49.9% of the sanctioned posts of specialists at CHCs were vacant. Moreover, there was a shortfall of 6110 specialists at the CHCs as compared to the requirement for existing infrastructure on the basis of existing norms.
Sanctioned Posts, A Significant Percentage Of Posts Are Vacant At All The Levels
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INFERENCE
AYUSH practitioners are roughly equal in numbers to the allopathic medical practitioners in the country, and in fact even more in some states. Although, like their allopathic counterparts, alternative practitioners also tend to be concentrated in and around urban areas, they present a significant resource base for the future of health systems and improved health outcomes in India.
INFERENCE
Several issues emerge from review of the current situation of human resources for health in India. The largest proportion of medical and paramedical professionals practice in the for-profit private sector, which tends to be concentrated in urban areas. This sector is the primary provider of curative health services in the country for which there is a huge demand. The smaller public sector is the primary provider for preventive and promotive care and some curative care.
INFERENCE
A greater number of well-trained human resources are required, now and in the future, to provide preventive, promotive and curative care especially in rural and urban underprivileged areas in the country. Furthermore, there exist a large number of AYUSH practitioners in the country, who are a valuable resources that need to be integrated into the health system in bolder and more efficient ways than before.
INFERENCE
Other human resources like public health specialists, health/hospital administrators, social workers, public health engineers, physiotherapists and clinical psychologist amongst others are providing health services. However, there is insufficient and inadequate information available about them.
REFERENCES:
GOI, Bulletin on Rural Health Statistics in India, 2006 Ministry of Health & Family Welfare, Govt. of India accessed from indiastat.com Dental Council of India Department of AYUSH, MOH&FW/GOI Pharmacy Council of India. Accessed from www. Indiastat. com Census of India 2001 GOI, MOHFW Annual Report 2005-06 WHO Report (NOT ENOUGH HERE, TOO MANY THERE)2006.