The lack of workforce is a major problem in India’s healthcare sector which means that the country's population lacks proper and quality care for health complications. Despite some progress in the area over the years, the demand is far from being met entirely.
People, particularly in rural areas, witness a severe demand and supply gap regarding healthcare resources. With the huge overcrowding of health facilities and longer waiting periods, patients receiving inadequate treatment have become more normal than anyone would want to accept. This shortage is an urgent problem that impacts millions of people and needs to be addressed at the earliest.
Currently, the doctor-to-patient ratio in India is reported at 1:854, which is better than the WHO standard of 1:1000. However, this data can be confusing because it lists practitioners of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) alongside those of Allopathy. The inclusion of these practitioners has only swelled the numbers and the actual figure regarding the availability of qualified allopathic doctors is still grim.
The situation is even worse in rural areas. The Rural Health Statistics (RHS) 2021 highlighted that currently there is a 57% percent shortage of doctors at CHCs. This fact reflects the general situation of doctors to population ratio, where 27 percent of doctors work in 60 percent of areas inhabited by 63 percent of Indian people. This difference underscores the necessity to increase the number of healthcare personnel in rural parts of India.
This problem does not just affect doctors but also nurses and midwives. India presently lacks 2 million nurses to serve the country’s healthcare needs. There is still a long way to reach the standard density of an active health worker, including nurses and midwives, which according to WHO’s benchmark is 44. 5 skilled healthcare workers for every 10,000 people. Currently, we are at 13.5 per 10,000 people. Such a severe scarcity results in overcrowding and longer waiting periods in hospitals, poor quality of health care, especially in rural and underserved regions.
ASHA and Anganwadi workers play a very important role in India’s healthcare system with their major focus on the rural part of the country. Although they are successfully employed in health facilities, they receive severe challenges because they are overworked and lack support.
ASHA workers are often engaged in several activities such as vaccination, checking on the children’s health, and promoting hygiene. Their work dimensions were expanded by the COVID-19 outbreak and included tasks such as contact tracing, and arranging for and distributing essentials. Yet, most ASHA workers are paid as little as INR 3,000 to INR 4,000 per month. Other fundamental issues also persist, such as nonpayment of promised COVID-19 bonuses.
Some of these employees purchase their protective gear and are exposed to many health hazards. They also undergo violence and abuse in the process of performing their duties. The failure to receive sufficient wages and support shows the necessity to change the situation of these women in the workforce and acknowledge them for their efforts.
India’s elderly people are projected to touch 340 million by 2050, up from about 120 million now. This demographic change will therefore lead to an increase in demand for healthcare services especially for diseases of the aged and other associated illnesses. Currently, the healthcare environment can hardly meet the demand for such a large number of highly skilled professionals, which only highlights the shortage of staff. The type of services provided to seniors is very limited and there is a scarcity of geriatric care along with few specialized facilities and personnel. This brings about a situation where many old people are not well taken care of, this ends up compromising their health, and their families are strained.
60% of deaths in India are caused by diabetes, cardiovascular diseases, and cancer. The increasing incidence of NCDs increases the demand for health services due to their specific treatment and lifelong nature. Huge deficits exist for highly skilled medical professionals, which greatly delays or even negates quality diagnosis and treatment of NCDs, thus increasing mortality rates among affected candidates.
Due to a lack of adequate numbers of healthcare workers, there is an injustice when it comes to the delivery of healthcare services. The worst of this crisis is borne directly by the rural population, in India which is 65% of the country’s population. A survey conducted in 2020 for the Public Health Foundation of India discovered that the likelihood of rural people not being able to access primary care services is 3X as compared to the urban population.
Limited and poor-quality public healthcare forces a huge population of Indians to seek treatment from the private sector hence, resulting in high out-of-pocket expenses. According to the National Health Profile 2020, 58.7% of people entirely bear the cost of their health care from their pockets thus pulling many families into poverty annually.
For these issues, some organizations operating in India are putting in their best effort to increase the number of healthcare workers in the country and enhance its quality. Let’s look at some of them:
SNEHA’s programs focus on urban slum health care, particularly in the case of mothers and children. They educate CHWs and help strengthen the health systems to achieve improved health outcomes. Their initiatives have helped in the capacity building of numerous front-line health care providers which in turn enhances health in the particular communities.
Engaging in education and nutrition, FMCH is the advocate of mothers' and children’s health. They also give local women knowledge on how to become health facilitators and how to handle some common health concerns.
Sambhav Foundation’s programs revolve around training healthcare workers mainly in the rural and remote areas. Thus, they make sure that vulnerable, underserved groups are provided with qualified specialists in health care.
CRY aims at child health enhancement by focusing on the preventive approach and education of community health workers. It targets the reduction of child deaths and diseases by capacity building of local healthcare workers and improving healthcare facilities.
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The WISH Foundation works towards empowering change in the health sector, specifically; Primary healthcare in India. LEHS|WISH partners with state governments and utilizes innovative approaches to improve primary healthcare access and quality, particularly in underserved areas and urban slums. Through technology-driven solutions and community engagement, it offers a comprehensive range of services, including RMNCH+A and disease management, while providing training and advisory support to local healthcare workers.
Government Initiatives
Recent Developments
Policy Recommendations
Healthcare has long been a major issue in India owing to the scarcity of a proper number of doctors and other healthcare practitioners, particularly in the villages. This results in increased cases of lack of equitable access to healthcare, increased out-of-pocket expenses, and poor health-related outcomes. However, the initiatives of NGOs like SNEHA, FMCH, Sambhav Foundation, CRY, and WISH Foundation are bringing about a change by training healthcare employees and upgrading services.
Government projects like the National Health Mission and Ayushman Bharat, the rise of telemedicine, and skill development programs have a solution for this. This gives us an opportunity to extend medical and nursing education with incentives for practice in rural areas, promote primary care, and use technology to close the gaps in health workforce and distribution and, hence, create a fair health workforce system.
This requires coordination from the government, Non-governmental organizations, and the private sector in which participation from the community is crucial. Strengthening the healthcare workforce and health systems in India will make healthcare affordable and accessible to all. Thus, the future for us and our children can be made a healthier one.
