India embarked on its health reform journey a decade ago. A need to address the ever-growing disease burden for a geographically and economically diverse population was recognised in the eleventh and twelfth Five Year Plan, with a host of initiatives and programmes at the onset. The private sector too pledged its participation. However, the current healthcare profile still showcases signs of significant gaps and deficiencies in skill development, availability of resources, safety concerns of medical staff, and infrastructure.
Today, outcomes in the Indian health sector straggle substantially behind those of peer nations with serious deficit of resources in number as well as in quality. The total number of allopathic doctors and nurses in the country continues to lag the WHO benchmark of 2.5 doctors per 1000 population, at 2.2 per 1000 people.
With the availability of only 7 doctors, 17 nurses/midwives, 1 dentist and 5 pharmaceutical personnel for every 10,000 patients, there exists a huge gap in the availability of trained healthcare professionals in India, which is the real barrier in providing accessible and quality healthcare to the 1.2 billion population of the country.
Deficit of skilled manpower remains one of the major challenges in strengthening the healthcare infrastructure today. Despite government’s efforts to tame disease burden and availability of effective interventions for many priority health problems, majority of population still continues to suffer due to unavailability of aid of skilled health personnel.
Adding to the existing workforce and promoting skill building will substantial improvement in healthcare space. Comprehensive skill development programmes of the existing workforce play an important role in this context and are imperative in tackling the inactivity of medical professionals by indirectly adding to the workforce.
Experts opine on the need to encourage a healthcare ecosystem conducive to the multiplication of medical professionals, i.e. doctors, nurses, and para medical staff, in the health sector in order to mitigate the existing talent crunch. A significant increase in healthcare workforce at micro and macro level has potential to manage the diverse disease burden in the country.
In fact, in a bid to improve the availability and quality of resources, government recently introduced national health policy that recommends strengthening of medical colleges and converting district hospital into new medical colleges to increase the number of medical professionals. It also advocates introducing training courses and curriculum for super specialty paramedical care (perfusionists, physiotherapists, occupational therapists, radiological technicians, audiologists, MRI technicians, etc.) which will hone their skills and improve quality of care provided by them.
Indian healthcare has been grappling with long standing problem of skilled resources deficit. With the government’s program to launch training modules and enhance quality of education, it is definitely a step forward in the right direction. We need more such efforts with the involvement of private sector, not-for-profit organizations and health experts to devise stringent strategies and programs to improve the overall health outcome in the country.
Realizing the urgent need to address the nationwide problem of skill deficit in healthcare realm, recently, Becton, Dickinson & Co (BD), one of the leading medical technology companies collaborated with the government investing in skilling and training available human capital.
We, at BD, India are undertaking number of ventures with the support of government and other healthcare forums to meet the huge demand for skilled human resources. BD has recently launched training programs for lab professionals to train them and support them in driving best practices in pre-analytical processes for more accurate diagnosis. Though these measures will definitely improve the paucity of skilled healthcare workers, still a lot needs to be done to bridge the existing gaps in the current.
On the infrastructure front, India still needs to go a long way to improve its record of accomplishment. The country showcased a bed density of 0.67 per 1000 population in the year 2002, significantly below the global average of 2.6 and WHO benchmark of 3.5. The situation is further complicated by inequity in healthcare access across states and demographic segments within the population.
There is one PHC (primary health center) for 30000 people in rural areas and one for 20000 people. In terms of community health centres, there is one CHC for 120,000 people in rural areas, and one for 80000 people in hilly and tribal areas. These figures show the significant dearth of health centers indicating clear gaps in healthcare infrastructure.
Recently, government took a strong position by introducing the health policy advocating the increase of resource allocation (up to two-thirds or more) for primary care followed by secondary and tertiary care, and recommending the development of specialized nursing training courses and curriculum to improve regulation and quality management of nursing education. These are the promising initiatives taken up by government to promote skill development and strengthening healthcare infrastructure but the success rate largely depends on their implementation which is something that needs to be looked at.
The government has long invested in articulating its dream to achieve universal health care, with an actionable blueprint incorporated in the Twelfth Five Year plan. But what chances does this dream have of realising with the health sector in its current form?
The healthcare sector is expected to drive the growth of the economy as well as play a significant role in employment. Presently, Indian Healthcare Industry is US$ 60 billion and is expected to reach US$ 250 billion by 2020.
It is abundantly clear that a status quo approach will be inadequate in tackling this challenging situation. The interventions to enhance the health sector in India have to move on from just ‘issue stating’ to problem solving.
Infrastructure gaps will need to be closed. Workforce utilisation and scarcity will need to be closely monitored. And in order to achieve all this, the government and private sector will need to collaborate closely, beginning with an inclusive and transparent dialogue to envision long term health system.