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Indian healthcare sector sees that without aggressive investment in medical education, training, and retention, shortages will continue to compromise patient care. The time to act is now because healthcare infrastructure is only as strong as the people who run it, said Dr Vivek Desai, founder & managing director, HOSMAC.
In India, access to quality healthcare is often a matter of geography and privilege. A doctor in a metro city may handle 20 patients a day, while a rural practitioner is stretched thin, catering to over 80. The reality is that India needs twice the doctors, three times the nurses, and four times the paramedics to bridge the gap, he added.
An industrial training institute (ITI) type for healthcare can be effective, offering multiple paramedic courses that not only build a skilled workforce but also generate employment opportunities. India’s healthcare aspirations cannot be met without a skilled workforce, stated Dr Desai.
World Health Organization (WHO) recommends a doctor-to-population ratio of 1:1000, yet India falls short, requiring twice the current number of doctors to bridge the gap. The shortage is even more severe among nurses and paramedics, with the country needing three times more nurses and four times more paramedics to meet growing healthcare demands. With an aging population, prevalence of lifestyle diseases, and an overburdened system, this shortfall has escalated into a healthcare crisis.
While efforts have been made to expand medical education through new colleges and training institutes, the rate of progress remains inadequate. Addressing this challenge requires a dual approach: significantly increasing the healthcare workforce and equipping existing professionals with advanced skills to meet modern medical standards.
Recognizing the severity of the healthcare workforce shortage, Union government has brought in Skill India, Ayushman Bharat Digital Mission, and the National Health Mission. Pradhan Mantri Kaushal Vikas Yojana (PMKVY) trained 1,24,284 healthcare workers during the Covid-19 in 2021, yet the demand continues to far exceed supply. Under the Centrally Sponsored Scheme (CSS), 157 government medical colleges are approved. However, expanding the medical workforce alone will not resolve the crisis as nurses, paramedics, and community health workers are equally essential in bridging the gap and ensuring comprehensive healthcare access. Moreover, India lacks super-specialty doctors in all streams, further limiting advanced medical care, he noted.
Nearly 70% of India’s population lives in rural areas, but only about 35% of the healthcare workforce is stationed there. Doctors prefer urban postings for better facilities and career growth, leaving Primary Health Centres (PHCs) and Community Health Centres (CHCs) woefully understaffed. The National Rural Health Mission (NRHM) has made efforts to strengthen rural healthcare, but a lack of trained personnel remains the biggest bottleneck, Dr Desai told Pharmabiz.
Only strengthening skill development is the way forward. Increasing seats in medical, nursing, and paramedical institutes is crucial with quality training. Fast-tracking diploma courses for paramedics can rapidly increase workforce numbers.
E-learning platforms and simulation-based training can bridge the skill gap efficiently, particularly in remote areas. Offering financial incentives, better infrastructure, and career progression for professionals working in rural areas can balance the urban-rural divide. Collaborations with private hospitals and NGOs can enhance training and deployment, especially for paramedics and allied healthcare workers. Expanding the roles of nurse practitioners, community health officers, and ASHAs (Accredited Social Health Activists) can ease the burden on doctors and improve primary healthcare access, said Dr Desai.
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