68% of specialist doctor posts vacant at rural CHCs: Health Ministry

Rural India suffers from a 68% shortage of specialist doctors like surgeons, paediatricians, obstetricians and gynecologists and physicians, according to the Centre’s new rural health report, which depicts the skewed nature of healthcare services available at thousands of community healthcare centres (CHC) in the countryside.

India requires nearly 22,000 specialist doctors for its 5,000 plus CHCs in rural areas. Against such a requirement, the total number of sanctioned posts are 13,637 of which 9,268 positions are vacant.

A closer look at the states shows Madhya Pradesh has 945 sanctioned positions, of which 902 are vacant while in Bihar out of 836 sanctioned posts, 730 are vacant. In Jharkhand 498 out of 684 positions have not been filled up whereas in Odisha more than 1,200 sanctioned posts, out of 1511, are empty.

Among the southern states, Karnataka and Telangana have more than 50% vacancy in the sanctioned posts of specialist doctors in the CHCs.

In Andhra Pradesh and Tamil Nadu, the situation is slightly better with 32% and 23% vacancy. Kerala is the only state with no such vacancy.

Read | Workers’ woes: Govt must address occupational safety issues urgently

As of March 31, 2021, out of the sanctioned posts, 72.3% of surgeons, 64% of obstetricians and gynaecologists, 69% of physicians and 67.1% of pediatricians are vacant, says the report.

“Lack of specialists is a genuine problem in many states due to an international transition of doctors to corporate hospitals,” T Sundararaman, former executive director of the National Health Systems Resource Centre, here told DH.

The situation has worsened over the years. At the national level, the shortage of specialists stood at 46% in 2005, which has now gone up to 68%. The situation remained more or less the same in the last two years.

“For the government, the primary or secondary care at rural CHCs is not the priority. Also, there is hardly any push from agencies like WHO or UNICEF. But if there is a dedicated manager at the health ministry and the government is serious, then there are models to improve the CHCs,” said Dileep Mavlankar, director, Indian Institute of Public Health, Gandhinagar.

Experts observed that the government did not pump enough resources into CHCs and did not look for innovative approaches to lure and retain specialists in villages.

“Students who pay huge capitation fees in private medical colleges, would not join government service after passing out. They would not be able to pay their loans if they work for the government. They would look for ways to recover the money,” said Sundararaman.

There is also a large-scale shortage of radiographers, nursing staff and laboratory technicians. For instance, Bihar has no radiographer in rural areas while Gujarat has eight.

The CHCs in 37 states and Union Territories have 1.06 lakh plus sanctioned posts of nurses of which close to 30,000 are vacant – a shortfall of 28%. The gap is significant in states like Bihar (68%), Odisha (49%), Uttar Pradesh (42%), Haryana (29%) and West Bengal (22%).