Active Y health workforce may be half of govt estimates: Study

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The active health workforce could be as low as 3.1 million as estimated in the NSSO periodic labour force surv...Read More

The health workforce actually available in India could be just over half of what is estimated by the government. Though migration of healthcare workers abroad is often cited as one of the foremost reasons for shortage of personnel, about a quarter of medically qualified persons available in India are out of the labour force, according to a just published study.
Instead of 5.8 million health workers as shown in the National Health Workforce Account (NHWA) 2018, the active health workforce could be as low as 3.1 million as estimated in the NSSO periodic labour force survey of 2017-18, concluded the study done by public health researchers at the Indian Institute of Public Health in Delhi that was published on Monday.
“Government calculations are usually made on the basis of registration of health professionals with the various councils, but these registers do not reflect those who migrated, died or did not join the workforce. Thus, the stock data in the NHWA does not reflect the actual availability,” Dr Anup Karan, the corresponding author of the study, told TOI.
The study also found that a substantial proportion of active health workers were not adequately qualified and hence needed reskilling. “A large proportion of medically qualified professionals, roughly 30% of the nurses and 20% of doctors, are not working. We also found that a large proportion of those not working are women, and mostly over 35 years. They don’t seem to find the labour market conducive for working,” said Dr Karan.
Going by the NSSO estimate, the density of human resources for health (HRH) per 10,000 population is just16.7 (6.1 doctors and10.6 nurses), which does not meet even the absolute minimum WHO threshold of 23 health workers per 10,000 population. This threshold was fixed in 2004-06 linked to one single health service, delivery by a skilled birth attendant, and hence counted only doctors and nurses. The NSSO estimate drops to just five doctors and six nurses per 10,000 persons after accounting for adequate qualifications.
In 2016, WHO revised the minimum threshold to 44.5 health professionals per 10,000 population taking into account a broader range of health services and the potential contribution of different types of health workers, beyond doctors, nurses or midwives. According to the study, the projected skilled health workforce numbers will rise from 1.77 million to 2.65 million in 2030. Yet, India will be short of 1.1 million health workers in 2030 to reach even the threshold of 25 health workers per 10,000. The density will be 17.5 per 10,000 population in 2030. The study suggests a scale-up of nursing supply to approximately 200% growth by 2030 to touch 2.02 million nurses by then could push the total workforce to 3.45 million or 22.76 skilled personnel per 10,000.
“The focus is on enhancing production. But the government must also invest to encourage those out of the workforce to join. Even if 50% of these professionals come back, it will be a big boost,” said Dr Karan.

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