A Holistic Prescription

The attempts by successive Indian governments to grapple with the problem of severe shortage of doctors in rural areas bring to mind the Sisyphean task: the king rolling a boulder uphill only to have it roll down as soon as it reaches the top. For decades now, governments have alternately tried the carrot and stick policy; medical students and well-qualified medical professionals remain reluctant to service rural India. A problem as complex and unyielding as this deserves a more nuanced and multifaceted handling. Now, the National Democratic Alliance (NDA) government, say media reports, is examining a proposal of its predecessor. But instead of making the rural posting compulsory for the MBBS students, it has decided to offer better pay and the chance to access a postgraduate seat stronger in return.

The situation in the hilly states, the North East and militancy-affected regions is worse. As it is, overall the doctor–patient ratio in the country is 1:1,700 when the World Health Organization calls for a minimum of 1:1,000. According to official statistics around 27% of the sanctioned doctors’ posts in primary health centres, 10% of auxiliary nurse midwife posts and 40% of male health worker posts are vacant presently. In the case of community health centres, 68% posts for specialist doctors, almost 75% of the sanctioned posts of surgeons, 65% of obstetricians and gynaecologists, 68% of physicians and 63% of paediatricians remain vacant.