Shortage of Allopathic Doctors

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Shortage of Allopathic Doctors 
As per information provided by Medical Council of India, there are a total 10,41,395 allopathic doctors registered with the State Medical Councils/Medical Council of India as on 30th September, 2017. Assuming 80% availability, it is estimated that around 8.33 lakh doctors may be actually available for active service. It gives a doctor-population ratio of 1:1596 as per current population estimate of 1.33 billion. However, WHO norms prescribes that there should be 1 doctor amongst the population of 1,000. State – wise details of doctors registered with State Medical Councils / Medical Council of India and number of PHCs with doctors working therein are given below:


Number of Doctors Registered with State Medical Councils / Medical Council of India  as on 31st  December, 2017

Sr.
Name of the Medical Council
Number of Doctors
  1.  
Andhra Pradesh Medical Council
86129
  1.  
Arunachal Pradesh Medical Council
840
  1.  
Assam Medical Council
22532
  1.  
Bihar Medical Council
40043
  1.  
Chattisgarh Medical Council
6915
  1.  
Delhi Medical Council
16176
  1.  
Goa Medical Council
3367
  1.  
Gujarat Medical Council
53954
  1.  
Haryana Dental & Medical Council
5717
  1.  
Himachal Pradesh Medical Council
2849
  1.  
Jammu & Kashmir
14326
  1.  
Jharkhand Medical Council
5093
  1.  
Karnataka Medical Council
104794
  1.  
Madhya Pradesh Medical Council
34347
  1.  
Maharashtra Medical Council
153513
  1.  
Medical Council of India
52666
  1.  
Nagaland Medical Council
801
  1.  
Orissa Council of Medical Registration
21681
  1.  
Punjab Medical Council
44682
  1.  
Rajasthan Medical Council
40559
  1.  
Sikkim Medical Council
893
  1.  
Tamil Nadu Medical Council
126399
  1.  
Travancore Medical Council
55251
  1.  
Uttar Pradesh Medical Council
71480
  1.  
Uttrakhand Medical Council
7060
  1.  
West Bengal Medical Council
66974
  1.  
Tripura Medical Council
0
  1.  
Telangana Medical Council
2354

Total
10,41,395
*The other State / UTs do not have their own Medical Registration Council. Hence, their workers get registration with the Councils of other neighbouring States.

NUMBER OF PHCs WITH DOCTORS AND WITHOUT DOCTOR/LAB TECHNICIAN/PHARMACIST


S. No.
State/UT
Total PHCs
functioning
with4+ doctors
with 3 doctors
with 2 doctors
with 1 doctor
without doctors
without lab tech.
without pharma
With lady

1
Andhra Pradesh
1147
11
31
476
629
0
364
329
518













2
Arunachal Pradesh
143
3
6
27
81
40
55
55
36













3
Assam
1014
67
63
182
626
76
87
110
183













4
Bihar
1899
439
41
56
1363
0
256
201
156













5
Chhattisgarh
785
0
6
71
318
390
303
185
66













6
Goa
24
5
7
9
3
0
0
0
18













7
Gujarat
1392
0
0
0
1392
0
0
0
516













8
Haryana #
366
3
22
97
187
57
144
106
110













9
Himachal Pradesh
538
0
3
20
469
69
446
229
95













10
Jammu & Kashmir
637
71
96
169
180
121
294
62
239













11
Jharkhand
297
1
1
40
147
108
204
207
37













12
Karnataka
2359
0
14
169
1973
203
507
531
627













13
Kerala
849
1
110
47
694
0
610
0
460













14
Madhya Pradesh
1171
4
17
180
577
393
525
382
119













15
Maharashtra
1814
0
0
1382
432
0
446
152
516













16
Manipur
85
54
14
10
6
1
33
19
53













17
Meghalaya
109
0
12
55
41
1
2
3
47













18
Mizoram
57
0
0
4
48
5
0
1
18













19
Nagaland
126
0
0
20
89
17
87
44
30













20
Odisha
1280
0
1
673
520
86
1239
134
507













21
Punjab
432
15
18
121
240
38
149
38
184













22
Rajasthan
2079
0
30
319
1563
167
669
1526
188













23
Sikkim
24
0
0
3
21
0
2
12
10













24
Tamil Nadu
1362
204
90
871
197
0
630
221
908













25
Telangana
689
20
13
269
387
0
48
31
390













26
Tripura
93
23
16
45
9
0
15
2
43













27
Uttarakhand
257
3
8
61
122
63
191
21
58













28
Uttar Pradesh
3621
26
88
735
2772
0
1252
0
319













29
West Bengal
914
2
12
169
592
139
623
143
112













30
A& N Islands
22
2
10
9
1
0
1
0
13













31
Chandigarh
3
0
1
1
2
0
0
0
2













32
D & N Haveli
9
0
0
9
0
0
0
0
5













33
Daman & Diu
4
0
2
0
2
0
0
0
2













34
Delhi
5
1
2
1
1
0
1
0
4













35
Lakshadweep
4
2
0
0
0
0
0
0
3













36
Puducherry
40
1
18
5
16
0
0
0
19














All India
Total
25650
958
752
6305
15700
1974
9183
4744
6611

1
For calculating the overall percentages, the States/UTs for which manpower position is not available, are excluded

****
Sending Doctors to Rural Areas

The issue of compulsory rural posting for the MBBS Graduates seeking admission in Post Graduate courses has been left to the State Governments who are the principal employer of doctors. However, to encourage doctors working in remote and difficult areas, the MCI with the previous approval of Central Government, has amended the Post Graduate Medical Education Regulations, 2000 to provide :-

50% of the seats in Post Graduate Diploma Courses shall be reserved for Medical Officers in the Government service, who have served for at least three years in remote and difficult areas. After acquiring the PG Diploma, the Medical Officers shall serve for two more years in remote and/or difficult areas; and


Incentive at the rate of 10% of the marks obtained for each year in service in remote or difficult areas as upto the maximum of 30% of the marks obtained in the entrance test for admissions in PostGraduate Medical Courses.


Further, under NHM, financial incentives are also provided to MBBS as well as PG doctors for serving in the rural areas. These incentives are over and above the salaries of the doctors concerned. The Central Government has also requested the State/UTs to come up with suitable HR policy in health to attract and retain doctors in Government services.

*****
Road Map for National Health Insurance Scheme

In the Budget Speech of 2018-19, the Government has announced to launch a flagship National Health Protection Scheme (NHPS) to cover over 10 crore poor and vulnerable families (approx. 50 crore beneficiaries) providing coverage upto Rs. 5 lakh per family per year for secondary and tertiary hospitalization. The contours of the scheme are yet to be finalized.

****
Research Projects through ICMR 2015

903 new research projects have been initiated through various labs of ICMR and medical colleges and universities, related to various diseases and ailments with funding of Rs.127.16 Crores during 2014-17. Besides this, AIIMS spends up to Rs. 5.0 Crore every year on various intramural research projects and funded extramural research projects for Rs.71 Crore during 2014-15 and for Rs.72 Crore during 2015-16.

Following ICMR technologies have been launched:

Diagnostic kit for Crimean-Congo haemorrhagic fever (CCHF) Sheep and Goat.
Diagnostic kit for Crimean- Congo haemorrhagic fever (CCHF) in Cattle.
Diagnostic kit for Japanese encephalitis virus (JEV) from Mosquito.
AV Magnivisualizer for detecting cancer lesions.


To get proper execution of the products developed out of the researches by Indian Council of Medical Research’s institutes, efforts are made for commercialisation of ICMR technologies under the programme “Health Technology Acceleration & Commercialization (HTAC)” through collaboration with the Federation of Indian Chambers of Commerce and Industry (FICCI).

****
Monthly Financial assistance to TB Patients

Under the Revised National Tuberculosis Control Programme (RNTCP), Government has proposed an incentive of  Rs.500 per patient per month for the nutritional support of the TB-affected patients during the course of the treatment. The States have the option for providing these incentives in cash or kind.

The Ministry has formulated the Guidance Document on nutritional care and support for TB patients which includes guidance on nutritional assessment, counselling and appropriate dietary advice.  The programme is also facilitating the TB patients to avail various social support schemes of the State Governments.

****
Increase in Cases of Respiratory Disease

Over past three years, cases of Acute Respiratory Infection (ARI) have increased. However, it cannot be attributed only to Air Pollution. The total numbers of Acute Respiratory Infection (ARI) cases as reported by the Central Bureau of Health Intelligence (CBHI) during the years 2014-16 are as follows:

Year 2014 2015 2016 (Prov.)
Cases 34835743 37485713 40303141



The measures being taken to prevent respiratory ailments include the following:



Government has taken various measures to control environmental pollution including tightening of vehicular and industrial norms, promotion of cleaner technologies, strengthening of network of air quality monitoring stations, promoting public awareness etc.


Under the Integrated Disease Surveillance Programme, the Districts and States have been strengthened by providing manpower, training of identified Rapid Response Team (RRT) members for outbreak investigations, strengthening of laboratories for detection of epidemic prone diseases including acute respiratory infections.


Under Reproductive and Child Health Programme, prevention and treatment of acute respiratory infection including pneumonia is being addressed on priority basis.


For prevention and control of Tuberculosis, Revised National Tuberculosis Control Programme (RNTCP) is being implemented under National Health Mission (NHM).

****
Fund Allocation for National Health Protection Scheme

 For the year 2018-19, Rs. 2000 crore has been allocated for Rashtriya Swasthya Bima Yojana (RSBY). After the launch of proposed National Health Protection Scheme (NHPS), RSBY will be subsumed in it. The budget earmarked for RSBY will be utilized for proposed NHPS. Any shortfall in the allocated funds will be met at the time of Revised Estimates.

There is a marginal increase of Rs. 1249.15 crore in Budget Estimate 2018-19 for Health compared to Revised Estimates in 2017-18.

****
White Paper on Non-Communicable diseases

The Government has formulated and brought out National Health Policy (NHP), 2017, which aims at attainment of the highest possible level of good health and well-being, through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence.



NHP has recognized the growing burden on account of Non-Communicable Diseases (NCDs) and advocated the need to halt and reverse the growing incidence of chronic diseases. This policy denotes important change from very selective to comprehensive primary health care package.



While Health is a State subject, the Central Government supplements the efforts of the State Governments for improving healthcare.



Government is implementing National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases andStroke (NPCDCS) under the National Health Mission.



For early diagnosis, Population-based Screening for common NCDs such as Diabetes, Hypertension and common Cancer viz. Oral, Breast and Cervical Cancer has been initiated by Government by utilizing the services of the Frontline-workers and Health-workers under existing Primary Healthcare System. This process will also generate awareness of risk factors of common NCDs.



In collaboration with the Ministry of AYUSH through its three research organizations, namely, Central Council for Research in Ayurvedic Sciences (CCRAS), Central Council for Research in Homoeopathy(CCRH) and Central Council for Research in Unani Medicine(CCRUM), a programme is being implemented in Gaya (Bihar), Bhilwara (Rajasthan) &Surendarnagar (Gujarat) for Ayurveda, LakhimpurKheri (Uttar Pradesh) for Unani and Darjeeling (West Bengal), Krishna (Andhra Pradesh), Sambalpur (Odisha) & Nasik (Maharashtra) for Homoeopathy to use the knowledge available in AYUSH system of medicines for prevention and control of Non-communicable Diseases.  Yoga is a part as adjuvant therapy.



Draft Model Concessionaire Agreements (MCA) has been prepared by NITI Aayog for provision of prevention and treatment services for non-communicable diseases (Cardiac Sciences, Oncology, and Pulmonary Sciences) at the district level, especially in tier 2 & 3 cities and has shared with States.  As informed by NITI Aayog, so far response has been received from 3 States namely Tamil Nadu, Haryana and Odisha.

****
Curbing Population Growth

Among the various reasons for most problems associated with providing healthcare and mployment, social security etc., population growth is one of the factors.



As per the 2017 revision of United Nations World Population prospects, India’s population is projected to be 1.50 billion by 2030 only.



The details of the schemes to restrict the ever increasing population in India are given below:



STEPS TAKEN TO CHECK THE INCREASE IN POPULATION ARE:

Mission ParivarVikas has been launched to increase access to contraceptives and Family Planning services in 146 high fertility districts.
Introduction of New Contraceptive Choices: The current basket of choice has been expanded to include the new contraceptives viz. Injectable contraceptive, Centchroman and Progesterone Only Pills (POP).
Redesigned Contraceptive Packaging: The packaging for Condoms, Oral Contraceptive Pills (OCPs) and Emergency Contraceptive Pills (ECPs) has now been improved and redesigned.
New Family Planning Media Campaign has been launched to generate demand for contraceptives.
Family Planning logistics management information system has been developed to track Family Planning commodities.
Enhanced Compensation Scheme for Sterilization: The sterilization compensation scheme has been enhanced in 11 high focus states (8 Empowered Action Group (EAG), Assam, Gujarat, Haryana)
National Family Planning Indemnity Scheme- Under this scheme clients are indemnified in the unlikely events of deaths, complications and failures following sterilization.
Clinical Outreach Team Scheme - The scheme has been launched in 146 Mission ParivarVikas districts for providing Family planning services through mobile teams from accredited organizations in far-flung, underserved and geographically difficult areas.
A Scheme for ensuring drop back services to sterilization clients has been initiated.
Post Abortion Family Planning Services have been initiated.
A Scheme for Home delivery of contraceptives by ASHAs to provide contraceptives at the doorstep of beneficiaries is in operation.
A Scheme to ensure spacing of births by ASHAs is in operation.
World Population Day & fortnight as well as Vasectomy Fortnight is observed every yearto boost Family Planning efforts all over the country.
Post-partum Family Planning is being focused with special emphasis on Post-partum IUCD services.
Quality Assurance Committees have been established in all state and districts for ensuring quality of care in Family Planning.
Cu IUCD 375 with 5 years effectivity has been introduced in the programme as an alternative to the existing IUCD (Cu IUCD 380A with effectivity of 10 years).
Male participation is being emphasized upon.
Private/ NGO facilities have been accredited to increase the provider base for family planning services under PPP.


As a result of Governments initiatives, the decadal growth rate has declined significantly from 21.15% in census 2001 to 17.64% in census 2011. Moreover the Crude Birth Rate (CBR) has reduced from 23.1 to 19, Total Fertility Rate (TFR) has reduced from 2.6 to 2.2 and Total Unmet Need has reduced from 13.9 to 12.9 from NFHS 3 (2005-06) to NFHS 4 (2015-16).


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