The real deficit in the health care system

Anew 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 on Universal Health Coverage recommends a nurse-doctor ratio of 3:1.

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 in developed countries. More than 30% of the doctors and 50% of the nurses are not part of the 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 implies, a PHFI calculation shows, that even if 100% of the new graduates join the workforce, it will take more than 10 years to add 250,000 professionals to the existing health workforce (170,000). To accelerate the pace, 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.