Abstract
BackgroundIn many developing countries, such as India, information on human resources in the health sector is incomplete and unreliable. This prevents effective workforce planning and management. This paper aims to address this deficit by producing a more complete picture of India’s health workforce.MethodsBoth the Census of India and nationally representative household surveys collect data on self-reported occupations. A representative sample drawn from the 2001 census was used to estimate key workforce indicators. Nationally representative household survey data and official estimates were used to compare and supplement census results.ResultsIndia faces a substantial overall deficit of health workers; the density of doctors, nurses and midwifes is a quarter of the 2.3/1000 population World Health Organization benchmark. Importantly, a substantial portion of the doctors (37%), particularly in rural areas (63%) appears to be unqualified. The workforce is composed of at least as many doctors as nurses making for an inefficient skill-mix. Women comprise only one-third of the workforce. Most workers are located in urban areas and in the private sector. States with poorer health and service use outcomes have a lower health worker density.ConclusionsAmong the important human resources challenges that India faces is increasing the presence of qualified health workers in underserved areas and a more efficient skill mix. An important first step is to ensure the availability of reliable and comprehensive workforce information through live workforce registers.
Highlights
In many developing countries, such as India, information on human resources in the health sector is incomplete and unreliable
In many developing countries, such as India, workforce planning is handicapped by the lack of comprehensive and reliable information on the number of health workers, what types operate, what their qualifications are and where they are located
Size and compositionb The Census estimates show that there were approximately 2.17 million health workers in India in 2005, which translates into a density of approximately 20 health workers per 10 000 population (Figure 1)
Summary
In many developing countries, such as India, information on human resources in the health sector is incomplete and unreliable This prevents effective workforce planning and management. In addition to overall numerical strength, health workforce effectiveness is influenced, among other things, by skill mix, type of providers and their geographical distribution. Information on indicators such as these is critical for policy makers to manage and plan better for the health workforce. RMPs are often the first point of contact for medical care for the rural population and the urban poor They typically practice allopathic medicine, but have no formal qualification or license to do so. A substantial number of practitioners of traditional medicine and faith healers inhabit the rural workforce space
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