Size, composition and distribution of health workforce in India: why, and where to invest?

Human Resources for Health

James Buchan¹  Hilde De Graeve²  Dilip Mairembam²  Anup Karan³  Himanshu Negandhi³  Suhaib Hussain³  Sanjay Zodpey³  Tomas Zapata⁴ 

[1] Faculty of Health, WHO Collaborating Centre, University of Technology, Sydney, Australia;Health Systems, World Health Organization, Office of the WHO Representative To India, 537, A Wing, Nirman Bhawan, Maulana Azad Road, 110 011, New Delhi, India;Indian Institute of Public Health-Delhi, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area, Sector 32, 122002, Gurugram, Haryana, India;South-East Asia Regional Office, Indraprastha Estate, World Health Organization, Mahatma Gandhi Marg, Outer Ring Rd, 110002, New Delhi, Delhi, India;

关键词: Health workforce;    Human resource for health;    Investment in health;    India;   

DOI  :  10.1186/s12960-021-00575-2

来源: Springer

【 摘 要 】

BackgroundInvestment in human resources for health not only strengthens the health system, but also generates employment and contributes to economic growth. India can gain from enhanced investment in health workforce in multiple ways. This study in addition to presenting updated estimates on size and composition of health workforce, identifies areas of investment in health workforce in India.MethodsWe analyzed two sources of data: (i) National Health Workforce Account (NHWA) 2018 and (ii) Periodic Labour Force Survey 2017–2018 of the National Sample Survey Office (NSSO). Using the two sources, we collated comparable estimates of different categories of health workers in India, density of health workforce and skill-mix at the all India and state levels.ResultsThe study estimated (from NHWA 2018) a total stock of 5.76 million health workers which included allopathic doctors (1.16 million), nurses/midwives (2.34 million), pharmacist (1.20 million), dentists (0.27 million), and traditional medical practitioner (AYUSH 0.79 million). However, the active health workforce size estimated (NSSO 2017–2018) is much lower (3.12 million) with allopathic doctors and nurses/midwives estimated as 0.80 million and 1.40 million, respectively. Stock density of doctor and nurses/midwives are 8.8 and 17.7, respectively, per 10,000 persons as per NHWA. However, active health workers’ density (estimated from NSSO) of doctor and nurses/midwives are estimated to be 6.1 and 10.6, respectively. The numbers further drop to 5.0 and 6.0, respectively, after accounting for the adequate qualifications. All these estimates are well below the WHO threshold of 44.5 doctor, nurses and midwives per 10,000 population. The results reflected highly skewed distribution of health workforce across states, rural–urban and public–private sectors. A substantial proportion of active health worker were found not adequately qualified on the one hand and on the other more than 20% of qualified health professionals are not active in labor markets.ConclusionIndia needs to invest in HRH for increasing the number of active health workers and also improve the skill-mix which requires investment in professional colleges and technical education. India also needs encouraging qualified health professionals to join the labor markets and additional trainings and skill building for already working but inadequately qualified health workers.

【 授权许可】

CC BY