IMA AP STATE DATA Analysis: by Dr.C.S.Raju-President.
In our quest to live long& healthy, there is a lot that we can do ourselves to improve our healthspan and lifespan. But we are still dependent on the overall health infrastructure of the region and country we reside in.
“I” is a ripple in a network of networks. None of us is an island and everything and everyone are interdependent. Just by virtue of living in India, you have an increased chance of contracting tuberculosis, dengue, malaria, typhoid, amebiasis, etc., whether you live on the 34th floor of a building facing the Arabian Sea or whether you are in the slums of Dharavi, the only difference being that if you are rich, your risk is lower and you have access to better treatment, compared to someone who is poor. And yet, it is not that straightforward. The richest person in Ranchi will still not get the same urgent treatment for acute stroke as a middle-class individual in Mumbai, because Ranchi lacks an acute stroke care unit, while Mumbai has at least three. Ranchi’s deficiencies are due to the lack of adequate, trained manpower and infrastructure, which no amount of individual money can surmount…and so on and so forth.
ఈ భూమి పై నివసిస్తున్న సమస్త జీవరాశులు ... అంతేకాదు సమస్త ప్రక్రుతి లోని ప్రతిదీ ఒకదానిపై ఒకటి, ఆధారపడి ఉండటమేకాదు, సర్వమూ, సమస్తమూ అవినాభావ సంబంధంలోనే ఉంటాయి. అందుకే ఎంత డబ్బు ఉన్నా , అత్యంత హీనమైన ప్రజా ఆరోగ్యరంగ మౌలిక సదుపాయాలున్న ఇండియా లాంటి దేశంలో మలేరియా,డెంగ్యూ లాంటి ట్రోపికల్ వ్యాధులనుండి తప్పించు కో లేరు.
It is inexplicable that in this age of Digital India and Aadhar, the authorities are unable to maintain a database of barely 10 lakh doctors.
let us try to analyse....
Investment in human resources for
health not only strengthens the health system, but also generates employment
and contributes to economic growth. India can gain from enhanced investment in
health workforce in multiple ways. This study in addition to presenting updated
estimates on size and composition of health workforce, identifies areas of
investment in health workforce in India.
Methods
We analyzed two sources of data: (i)
National Health Workforce Account (NHWA) 2018 and (ii) Periodic Labour Force
Survey 2017–2018 of the National Sample Survey Office (NSSO). Using the two
sources, we collated comparable estimates of different categories of health
workers in India, density of health workforce and skill-mix at the all India
and state levels.
Results
The study estimated (from NHWA 2018) a total stock of 5.76 million health workers which included allopathic doctors (1.16 million), nurses/midwives (2.34 million), pharmacist (1.20 million), dentists (0.27 million), and traditional medical practitioner (AYUSH 0.79 million). However, the active health workforce size estimated (NSSO 2017–2018) is much lower (3.12 million) with allopathic doctors and nurses/midwives estimated as 0.80 million and 1.40 million, respectively. Stock density of doctor and nurses/midwives are 8.8 and 17.7, respectively, per 10,000 persons as per NHWA. However, active health workers’ density (estimated from NSSO) of doctor and nurses/midwives are estimated to be 6.1 and 10.6, respectively. The numbers further drop to 5.0 and 6.0, respectively, after accounting for the adequate qualifications. All these estimates are well below the WHO threshold of 44.5 doctor, nurses and midwives per 10,000 population.
The results
reflected highly skewed distribution of health workforce across states,
rural–urban and public–private sectors. A substantial proportion of active
health worker were found not adequately qualified on the one hand and on the
other more than 20% of qualified health professionals are not active in labor
markets.
Conclusion
India needs to invest in HRH for increasing the number of active health workers and also improve the skill-mix which requires investment in professional colleges and technical education. India also needs encouraging qualified health professionals to join the labor markets and additional trainings and skill building for already working but inadequately qualified health workers
After checking indian medical registry and other statistical data like NSSO,CENSUS and NATIONAL HEALTH WORKERS ACCOUNT- the number of living and practicing “qualified” doctors is likely 675000 (DP ratio 0.5:1,000), which is an availability of just 53% of those registered.
మరి ఈ డాక్టర్ : ప్రజల నిష్పత్తిని పెంచలేమా?
You might turn around and say that the situation will improve significantly in the future. After all, we have the largest number of medical colleges in the world (595 as of Jan 2022) with an intake of 89395 students in the last year . If 80% of these students complete their MBBS, and 75% of them remain in India to practice, we will add at least 53000 doctors per year.
The new WHO norms of 44 healthcare workers (doctors, nurses, technologists) per 10,000 population (4.4/1000) . It is the same story with nurses (just double the doctor numbers) and technologists.
The chart below summarizes these doctor numbers.
Interestingly 52 per cent of these doctors are practising in just five States — Maharashtra, Tamil Nadu , Karnataka, Andhra Pradesh and Uttar Pradesh.
it is estimated that around 6.30 lakh AUH doctors may be actually available for service and, considered together with Allopathic doctors, it gives a doctor population ratio of 1:848.
There are 8,85,383 auxiliary nurses and midwives, 21,29,820 registered nurses and registered midwives (RN&RM) and 56,644 lady health visitors in India.
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