Size, composition and distribution of human resource for health in India: new estimates using National Sample Survey and Registry data.
TL;DR: In this article, the authors provide new estimates on size, composition and distribution of human resource for health in India and compare with the health workers population ratio as recommended by the WHO.
Abstract: Objectives We provide new estimates on size, composition and distribution of human resource for health in India and compare with the health workers population ratio as recommended by the WHO. We also estimate size of non-health workers engaged in health sector and the size of technically qualified health professionals who are not a part of the health workforce. Design Nationally representative cross-section household survey and review of published documents by the Central Bureau of Health Intelligence. Setting National. Participants Head of household/key informant in a sample of 101 724 households. Interventions Not applicable. Primary and secondary outcome measures The primary outcome was the number and density of health workers,and the secondary outcome was the percentage of health workers who are technically qualified and the percentage of individuals technically qualified and not in workforce. Results The total size of health workforce estimated from the National Sample Survey (NSS) data is 3.8 million as of January 2016, which is about 1.2 million less than the total number of health professionals registered with different councils and associations. The density of doctors and nurses and midwives per 10 000 population is 20.6 according to the NSS and 26.7 based on the registry data. Health workforce density in rural India and states in eastern India is lower than the WHO minimum threshold of 22.8 per 10 000 population. More than 80% of doctors and 70% of nurses and midwives are employed in the private sector. Approximately 25% of the currently working health professionals do not have the required qualifications as laid down by professional councils, while 20% of adequately qualified doctors are not in the current workforce. Conclusions Distribution and qualification of health professionals are serious problems in India when compared with the overall size of the health workers. Policy should focus on enhancing the quality of health workers and mainstreaming professionally qualified persons into the health workforce.
Citations
More filters
01 Jan 2010
TL;DR: In this article, the International Seminar on Information and Communication Technology Statistics, 19-21 July 2010, Seoul, Republic of Korea, 19 and 21 July 2010 was held. [
Abstract: Meeting: International Seminar on Information and Communication Technology Statistics, Seoul, Republic of Korea, 19-21 July 2010
619 citations
TL;DR: India 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.
Abstract: Investment 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. We 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. The 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. India 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.
67 citations
TL;DR: It is clear that without significant interventions, South Africa is likely to have a critical shortfall of Audiologists and Speech Therapists in 2030 and policy-makers will have to carefully examine issues surrounding the current framework regulating training of these and associated professionals, in order to respond adequately to future requirements.
Abstract: Audiologists and Speech Therapists play a vital role in addressing sustainable development goals by supporting people who are marginalised due to communication challenges The global burden of disease and poor social living conditions impact negatively on the development of healthy communication, therefore requiring the services of Audiologist and Speech therapists Against this background, we examined the demographic profile and the supply, need and shortfall of Audiologists and Speech Therapists in South Africa The data set was drawn from the Health Professions Council of South Africa (HPCSA) registers (for 2002–2017) for the speech, language and hearing professions This demographic profile of the professions was created based on the category of health personnel; category of practice, geographical location, population group (race) and sex The annual supply was estimated from the HPCSA database while the service–target approach was used to estimate need Additional need based on National Health Insurance Bill was also included Supply–need gaps were forecast according to three scenarios, which varied according to the future intensity of policy intervention to increase occupancy of training places: ‘best guess’ (no intervention), ‘optimistic’ (feasible intervention), and ‘aspirational’ (significant intervention) scenarios up to 2030 Most (ie 1548, 474%) of the professionals are registered as Audiologists and Speech Therapists, followed by 335% registered as Speech Therapists and 191% registered as Audiologists Around 885% professionals registered as Audiologists and Speech Therapists are practising independently, and 426% are practising in the Gauteng province The profession is comprised majorly of women (946%), and in terms of the population groups (race), they are mainly classified as white (597%) In 2017, in best guess scenario, there is a supply–need gap of around 2800 professionals In the absence of any intervention to increase supply capacity, this shortfall will remain same by the year 2030 By contrast, in aspirational scenario, ie supply is increased by 300%, the forecasted shortfall for 2030 reduces to 2300 from 2800 professionals It is clear that without significant interventions, South Africa is likely to have a critical shortfall of Audiologists and Speech Therapists in 2030 Policy-makers will have to carefully examine issues surrounding the current framework regulating training of these and associated professionals, in order to respond adequately to future requirements
48 citations
Cites background or result from "Size, composition and distribution ..."
...ment of human resources for health (HRH) in the future [18, 19]....
[...]
...sumptions adopted were similar to previously undertaken HRH forecasting studies [18, 19]....
[...]
TL;DR: In this article , the authors used spatiotemporal Gaussian process regression (ST-GPR) to estimate human resources for health (HRH) densities globally, and examined the relationship between a subset of HRH cadres and UHC effective coverage performance.
46 citations
TL;DR: Considerable expansion of the world's health workforce is needed to achieve high levels of UHC effective coverage, and the largest shortages are in low-income settings, highlighting the need for increased financing and coordination to train, employ, and retain human resources in the health sector.
42 citations
References
More filters
01 Jan 2010
TL;DR: In this article, the International Seminar on Information and Communication Technology Statistics, 19-21 July 2010, Seoul, Republic of Korea, 19 and 21 July 2010 was held. [
Abstract: Meeting: International Seminar on Information and Communication Technology Statistics, Seoul, Republic of Korea, 19-21 July 2010
619 citations
TL;DR: The effect of this density in reducing maternal mortality is greater than in reducing child mortality, possibly because qualified medical personnel can better address the illnesses that put mothers at risk.
614 citations
TL;DR: A comprehensive national policy for human resources is needed to achieve universal health care in India and additional investments will be needed to improve the relevance, quantity, and quality of nursing, medical, and public health education in the country.
407 citations
"Size, composition and distribution ..." refers background in this paper
...Physiotherapists and diagnostic and other technicians with varied levels of diploma and certificate also perform crucial activities as healthcare workers.(5) Several studies in the past have estimated the size and composition of HRH in India....
[...]
TL;DR: This report proposes a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems, and develops an illustrative and partial country typology to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa.
198 citations
"Size, composition and distribution ..." refers background in this paper
...In general, a little over 50% of all doctors in India are produced by government medical colleges, and more than 80% of them are employed in private institutions or work as private practitioners.(20) 27 Although it cannot be argued that all those who studied in public institutions should only work in the public sector, it may not be out of order to expect that professionals passing out from public institutions must be sufficiently sensitive to public health issues and may extend their services at least in some proportion to public sector facilities....
[...]
TL;DR: Although the production of health workers has expanded greatly in recent years, the problems of imbalances in their distribution persist and the realization of this goal remains challenged by the current lack of availability and inequitable distribution of appropriately trained, motivated and supported health workers.
Abstract: Background: India faces an acute shortage of health personnel Together with inequalities in distribution of health workers, this shortfall impedes progress towards achievement of the Millennium Development Goals The aim of this study was to assess health-workforce distribution, identify inequalities in health-worker provision and estimate the impact of this maldistribution on key health outcomes in India Materials and Methods: Health-workforce availability and production were assessed by use of year-end data for 2009 obtained from the Indian Ministry of Statistics and Programme Implementation Inequalities in the distribution of doctors, dentists, nurses and midwives were estimated by use of the Gini coefficient and the relation between health-worker density and selected health outcomes was assessed by linear regression Results: Inequalities in the availability of health workers exist in India Certain states are experiencing an acute shortage of health personnel Inequalities in the distribution of health workers are highest for doctors and dentists and have a significant effect on health outcomes Conclusion: Although the production of health workers has expanded greatly in recent years, the problems of imbalances in their distribution persist As India seeks to achieve universal health coverage by 2020, the realization of this goal remains challenged by the current lack of availability and inequitable distribution of appropriately trained, motivated and supported health workers
111 citations