Issues of creating a new cadre of doctors for rural India

Abstract

'Health gaps between countries and among social groups within countries have widened'. Health is a basic need of a human being and access to health is a basic human right. Article 47 of the Indian Constitution enjoins the State to improve the standard of Public Health, as it is one of its primary duties. India, forms 17% of the global population and accounts for 20% of the total global disease burden. There are pronounced disparities existing between the rural and urban areas, as indicated by the infant mortality rates. Eighty-two percent are residing in villages. Seventy-four percent of the doctors live in urban areas, serving only 28% of the population. The people in rural areas are still unable to access the services of doctors. In this scenario the Ministry of Health (MOH) Government of India (GOI) announced the start of a new course, to create a cadre of rural doctors. The article will look at the shortfalls in the rural health of India as well as region- and statewise disparities in health status, health infrastructure, and manpower availability and the study was conducted by a literature review of government reports and published articles. There exist gross disparities between rural and urban areas due to negligence of the rulers. Even after initiation of the National Rural Health Mission (NRHM) greater than two-thirds of the funds flow to the urban areas/secondary care. The population based on the 2001 census, shows a shortfall in the rural health infrastructure; Community Health Centers (CHC) - 68%, Primary Health Centers (PHC) - 31%, and Subcenters - (SC) - 29%. The solution by creating a new cadre of doctors without improving facilities in the rural areas or without an equitable distribution of resources is unethical. The scarcity of health manpower in rural areas of India was due to skewed prioritization and distribution of resources. This can be corrected by reversing the urban centric planning and bringing equity in social development.