The availability of doctors amid the unprecedented crisis in India has emerged as a major challenge due to the dual disease burden—the covid-19 pandemic, as well as existing ailments requiring medical care. The country is thus moving away from a doctor-centric health system to one that is increasingly multidisciplinary, said Arun Singhal, special secretary, ministry of health and family welfare, in an interview. Singhal spoke about human resources for healthcare, budgets, ventilators, personal protection equipment (PPE), and the impact of covid-19 on medical education in India. Edited excerpts:
How are you coping with the shortage of doctors and nurses during the covid-19 pandemic, considering that there is a surge in demand for healthcare services across India?
India is rapidly moving away from a doctor-centric health system to one that is increasingly multidisciplinary, one that is being led by the doctor, but involves various kinds of specialized health workers to increase system efficiency. This could not be more relevant than in the case of covid-19. Here, we have taken an approach of streamlining care provision in a staggered manner and, perhaps for the first time, defined and mapped roles of each of these workers specific to covid-19, while mapping their availability for each district and state.
India has about 70 lakh health workers of various categories, according to the health ministry’s detailed data review in September 2019. We estimate the availability of about 920,000 qualified allopathic doctors and specialists, 1.55 million nurses, about 750,000 nurse associates, or auxiliary nurse midwives (ANMs), about 200,000 dentists, almost 600,000 AYUSH qualified practitioners, about 1.1 million pharmacists, about 700,000 qualified allied and healthcare professionals, including those in laboratories, radiology, physiotherapy, optometry, occupational therapy, nutrition, and life sciences. In addition, we also have close to 1 million ASHA workers who take care of outreach services. While we definitely acknowledge the maldistribution of staff, there is no “absolute shortage” as is commonly perceived.
Several medical and AYUSH students have been readied to undertake field surveillance under the guidance of a field supervisor, who needs to have the necessary public health expertise. In the intensive care units, we are training respiratory therapists and physician associates to stand by along with anaesthesiologists and intensive care unit (ICU) specialists, and help them cater to a large number of critical patients, as they are well trained in the management of ventilators.
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