NEW DELHI: Around 54% of health professionals including doctors, nurses, midwives and other paramedics in India do not have required qualifications, whereas 20% of adequately qualified doctors are not in the current workforce, a new study in the British Medical Journal (BMJ) shows highlighting concerns about a severe dearth of quality care across the country, particularly in the hinterland.
Pointing at a significant disparity between the number of registered health professionals and those who are actually practicing, the findings of the study show health workforce number around 3.8 million under the National Sample Survey (NSS). But this number is about 1.2 million less than the total number of health professionals registered with different councils and associations.
Of the currently working health professionals, around 25% do not have the required qualifications as laid down by professional councils, the study says.
The density of doctors and nurses and midwives per 10,000 population is 20.6 according to the NSS and 26.7 based on the registry data, reflecting a widening gap between demand and supply of health resources which is already in shortage.
The study, conducted by researchers from the Indian Institute of Public Health and the Public Health Foundation of India, was designed on a nationally representative cross-section household survey and review of published documents by the Central Bureau of Health Intelligence.
“Distribution and qualification of health professionals are serious problems in India when compared with the overall size of the health workers. Policy should focus on enhancing the quality of health workers and mainstreaming professionally qualified persons into the health workforce,” the authors of the study concluded.
The level of required qualifications considered for doctors (allopathic, dental and AYUSH) was graduate or postgraduate in medicine; for nurse and midwife higher secondary with technical education in medicine or related field; and for others higher secondary with technical education in paramedical related fields.
The findings show more than 58% of all health workers are male. The proportion of males is higher in allopathic, AYUSH and dental categories, and lower in the nurse and midwife category. Around 80% of all health workers are in the 25–60 years age group. Around 30% of all health workers, 15% among allopathic doctors, reported their educational level below the higher secondary level. Most of the health workers reported to be employed as regular wage earners (57%). However, as high as 63% of allopathic and 88% of AYUSH doctors reported themselves as self-employed.
More than 80% of doctors and 70% of nurses and midwives are employed in the private sector.