Size, composition and distribution of human resource for health in India: new estimates using National Sample Survey and Registry data
Authors
Anup Karan
Indian Institute of Public Health, Delhi, Public Health Foundation of India, Gurugram, Haryana, India
Himanshu Negandhi
Indian Institute of Public Health, Delhi, Public Health Foundation of India, Gurugram, Haryana, India
Rajesh Nair
Indian Institute of Public Health, Delhi, Public Health Foundation of India, Gurugram, Haryana, India
Anjali Sharma
Academics, Public Health Foundation of India, Gurugram, Haryana, India
Ritika Tiwari
Academics, Public Health Foundation of India, Gurugram, Haryana, India
Sanjay Zodpey
Indian Institute of Public Health, Delhi, Public Health Foundation of India, Gurugram, Haryana, India
Keywords:
India, health workers, human resources for health, health associate workers, composition of HRH
Abstract
Objectives
We provide new estimates on size, composition and distribution of human resource for health in India and compare with the health workers population ratio as recommended by the WHO. We also estimate size of non-health workers engaged in health sector and the size of technically qualified health professionals who are not a part of the health workforce.
Design
Nationally representative cross-section household survey and review of published documents by the Central Bureau of Health Intelligence.
Setting
National.
Participants
Head of household/key informant in a sample of 101 724 households.
Interventions
Not applicable.
Primary and secondary outcome measures
The primary outcome was the number and density of health workers, and the secondary outcome was the percentage of health workers who are technically qualified and the percentage of individuals technically qualified and not in workforce.
Results
The total size of health workforce estimated from the National Sample Survey (NSS) data is 3.8 million as of January 2016, which is about 1.2 million less than the total number of health professionals registered with different councils and associations. The density of doctors and nurses and midwives per 10 000 population is 20.6 according to the NSS and 26.7 based on the registry data. Health workforce density in rural India and states in eastern India is lower than the WHO minimum threshold of 22.8 per 10 000 population. More than 80% of doctors and 70% of nurses and midwives are employed in the private sector. Approximately 25% of the currently working health professionals do not have the required qualifications as laid down by professional councils, while 20% of adequately qualified doctors are not in the current workforce.
Conclusions
Distribution and qualification of health professionals are serious problems in India when compared with the overall size of the health workers. Policy should focus on enhancing the quality of health workers and mainstreaming professionally qualified persons into the health workforce.
Keywords: India, health workers, human resources for health, health associate workers, composition of HRH
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