TY - JOUR
T1 - Human resources for health in India
AU - Rao, Mohan
AU - Rao, Krishna D.
AU - Kumar, Ak Shiva
AU - Chatterjee, Mirai
AU - Sundararaman, Thiagarajan
N1 - Funding Information:
After independence, the government attempted to improve the state of nursing in the country through standardisation of nursing education and increasing the resources for training public health nurses and midwives. However, despite such efforts, the nursing profession (and other cadres such as auxiliary nurse midwives, technicians, and community health workers) in India is in a state of neglect. The reasons for this neglect include the establishment of a doctor-centric health system and inadequate financial support from the government. 11
Funding Information:
The Indian Government's inattention to the shortages in the numbers of health workers and the simultaneous promotion of health-worker migration, draws attention to the government's thinking that the numbers of doctors and nurses are adequate, or that the numbers leaving are not large enough to affect the health services. Health-worker migration, especially for those whose training is funded by the public, is a substantial loss of scarce public resources. The number of doctors and nurses leaving the country has important implications for the capacity and quality of health services, research, and faculty development for training future generations.
Funding Information:
Since independence, access to medical education has increased substantially in India. At the time of independence, India had 19 medical schools, from which 1200 doctors graduated every year. 51 Nowadays, according to the Medical Council of India, India has roughly 270 medical schools, from which 28 158 doctors graduate every year. 52 Private medical institutions have helped this rapid increase in medical education ( figure 4 ). 53 In 1990, 33% of 135 medical schools were privately operated; nowadays, 57% are privately operated. Private medical schools include those managed by faith-based organisations and private trusts and societies. 51 Government medical colleges are mostly funded by state governments and municipal corporations; fewer are supported by central government. 51 The rapid increase in the number of medical colleges has drawn attention to the problem of poor quality of medical education being provided ( panel 5 ).
Funding Information:
We thank Aarushi Bhatnagar and Oommen C Kurian for his assistance. The Lancet Series on India: Towards Universal Health Coverage was supported by grants from the John T and Catherine D MacArthur Foundation and the David and Lucile Packard Foundation to the Public Health Foundation of India.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2011
Y1 - 2011
N2 - India has a severe shortage of human resources for health. It has a shortage of qualified health workers and the workforce is concentrated in urban areas. Bringing qualified health workers to rural, remote, and underserved areas is very challenging. Many Indians, especially those living in rural areas, receive care from unqualified providers. The migration of qualified allopathic doctors and nurses is substantial and further strains the system. Nurses do not have much authority or say within the health system, and the resources to train them are still inadequate. Little attention is paid during medical education to the medical and public health needs of the population, and the rapid privatisation of medical and nursing education has implications for its quality and governance. Such issues are a result of underinvestment in and poor governance of the health sector - two issues that the government urgently needs to address. A comprehensive national policy for human resources is needed to achieve universal health care in India. The public sector will need to redesign appropriate packages of monetary and non-monetary incentives to encourage qualified health workers to work in rural and remote areas. Such a policy might also encourage task-shifting and mainstreaming doctors and practitioners who practice traditional Indian medicine (ayurveda, yoga and naturopathy, unani, and siddha) and homoeopathy to work in these areas while adopting other innovative ways of augmenting human resources for health. At the same time, additional investments will be needed to improve the relevance, quantity, and quality of nursing, medical, and public health education in the country.
AB - India has a severe shortage of human resources for health. It has a shortage of qualified health workers and the workforce is concentrated in urban areas. Bringing qualified health workers to rural, remote, and underserved areas is very challenging. Many Indians, especially those living in rural areas, receive care from unqualified providers. The migration of qualified allopathic doctors and nurses is substantial and further strains the system. Nurses do not have much authority or say within the health system, and the resources to train them are still inadequate. Little attention is paid during medical education to the medical and public health needs of the population, and the rapid privatisation of medical and nursing education has implications for its quality and governance. Such issues are a result of underinvestment in and poor governance of the health sector - two issues that the government urgently needs to address. A comprehensive national policy for human resources is needed to achieve universal health care in India. The public sector will need to redesign appropriate packages of monetary and non-monetary incentives to encourage qualified health workers to work in rural and remote areas. Such a policy might also encourage task-shifting and mainstreaming doctors and practitioners who practice traditional Indian medicine (ayurveda, yoga and naturopathy, unani, and siddha) and homoeopathy to work in these areas while adopting other innovative ways of augmenting human resources for health. At the same time, additional investments will be needed to improve the relevance, quantity, and quality of nursing, medical, and public health education in the country.
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U2 - 10.1016/S0140-6736(10)61888-0
DO - 10.1016/S0140-6736(10)61888-0
M3 - Review article
C2 - 21227499
AN - SCOPUS:79951552530
SN - 0140-6736
VL - 377
SP - 587
EP - 598
JO - The Lancet
JF - The Lancet
IS - 9765
ER -