‘2 of 3 ‘docs’ in rural India have no formal medical degrees’

NEW DELHI : At least two of every three “doctors” in rural parts of India are informal providers of care, with no qualifications in modern system of medicine, according to India’s first comprehensive assessment of public and private health care availability and quality, as measured by their medical knowledge.

Although 75% of villages have at least one health care provider and a village on average has three primary health providers, 86% of them are private “doctors” and 68% have no formal medical training, found a survey of 1,519 villages across 19 states in 2009 by researchers from the Centre for Policy Research (CPR) in New Delhi.

The study by the Centre for Policy Research has been published in the Social Science and Medicine journal.

The Centre for Policy Research study found that formal qualifications were not a predictor of quality-the medical knowledge of informal providers in Tamil Nadu and Karnataka was higher than that of trained doctors in Bihar and Uttar Pradesh.

“Public health clinics and/or MBBS doctors are so few and far between that they are just not an option for most villagers. I knew that this was true of places that I had worked in (Madhya Pradesh and West Bengal), but had not realised that this generalised to almost every state, except Kerala,” said lead author Jishnu Das, professor at Mccourt School of Public Policy and the Walsh School of Foreign Service, Georgetown University, US, on email.

“Any strategy that does not account for the fact that most of our primary care is delivered by these providers cannot work at this moment,” said Das, who led the study called, ‘Two Indias: The structure of primary health care markets in rural Indian villages with implications for policy’.

The study found no correlation between the availability of care providers and health indicators such as child mortality, which shows that though villagers can choose from multiple providers, they still do not get quality care.