1 Doctor Per 1,000 Isn’t Healthcare’s Magic Number

Source– The post is based on the article “1 Doctor Per 1,000 Isn’t Healthcare’s Magic Number” published in The Indian Express on 9th September 2022.

Syllabus: GS2- Issues related to development and management of health.

News: The article explains India’s obsession with achieving WHO recommendation of 1 doctor per 1000 population and neglecting other aspects of the public healthcare system.

The National Medical Commission website shows 692 medical colleges with 92,793 seats.

How does India perform when compared with countries in the same economic category?

Sri Lanka-In 2000, its doctor population ratio was lower than India but health indices were better than India. It had a maternal mortality rate of 56 in 2000 compared with 370 in India.

Countries like Bangladesh, Indonesia and Vietnam have better health indices than India despite having lower doctor-population ratio. In contrast, Pakistan’s case is the reverse.

What are the possible reasons for better health in other lower- and middle-income countries despite the lower doctor-population ratio?

There is a strong emphasis on public health, a conscious move away from doctor-driven health systems. Furthermore, they have been focusing on improving social determinants of health such as access to clean drinking water, sanitation, education, and food security.

Sri Lanka case: From 1980s, it worked on maternal health surveillance and training to midwives to improve use of antenatal and natal services. It has not allowed privatization of medical education till date.

Iran case: It has established a network of “rural health houses” by recruiting workers from the community and giving them proper training.

What are the challenges faced by the current healthcare setup in India?

First, there is the collapse of the three-tier healthcare system, and rampant privatization of healthcare.

Second, India’s obsession with quantity has resulted in a large number of colleges without inadequate infrastructure and facilities, and inadequate, not enough faculty. Colleges for nursing and paramedical staff are in the worst condition.

Third, on paper the number of healthcare staff are increasing but in reality, in rural India, there is an acute shortage of doctors and nursing staff. They end up moving to other countries or adding to the number in cities.