The aim of this three-part series has been to explore some of the domestic challenges that India faces while it tries to balance the healthcare demands of its citizens with those of lucrative paying customers from abroad who wish to access our nation’s exemplary medical services. Unfortunately, India has been hindered by numerous systemic, logistic, and economic issues which have made it difficult—if not impossible—for the average men, women, and children of our nation to receive the medical care that they need and deserve.
One of the largest challenges facing India’s healthcare system is an extreme shortage of medical professionals. In March of 2015, an industry report released by Deloitte emphasized that India’s healthcare infrastructure falls far short when compared to nations like the United States and Japan. For example, India has only one hospital bed for every 1,050 patients whereas the United States’ bed/patient ration is 1/350 and Japan’s ratio is 1/85. Such bed shortages are compounded by a lack of healthcare professionals that is shameful, placing India well below the standards set by the World Health Organization (WHO). Currently, there are 0.7 doctors and 1.5 nurses for every 1000 people in the country, in comparison to the WHO’s recommendation of 2.5 doctors and nurses per 1000 people. India’s low ratio of doctors and nurses to patients is a major obstacle to the nation’s ability to care effectively for its population and meet or exceed the health care offered in more developed countries, and is substantially worsened by shortages in other areas of health care like administration and paramedical positions like laboratory technicians. Such shortages are ironic when one considers the major investments that India has made in training doctors and other healthcare professionals, providing it with one of the largest healthcare education systems in the world. However, at the heart of our shortages is the issue of choice, with many new graduates wishing to turn their skills into lucrative careers; thus, the ‘brain drain’ has exacted a high toll upon India as newly-minted doctors and nurses take their skills to countries like Canada, Britain, and the United States.
As noted in the second part of this series, patients in rural communities tend to suffer the most because of these shortages because the majority of healthcare professionals live in urban areas which contain only 30 percent of the nation’s population. Although the three-tiered approach utilized in rural health care outlines the importance of having multiple points of contact for potential patients and a plethora of medical and paramedical professionals, reality fails to measure up to ideal expectations. For example, a recent report in The Lancet medical journal states that as of March of this year more than 8 percent of the country’s primary health care centers did not have a doctor, 38 percent lacked lab technicians, and 22 percent did not have a pharmacist. Shortages are even worse in rural community health centers where an average of 80 percent of facilities lack a surgeon, obstetrician, gynecologist, physician, and/or pediatrician.
Deloitte’s report recommends an influx of 1.54 million doctors and 2.4 million nurses to meet global averages. However, past and current attempts to cure shortages through compulsory rural service has failed catastrophically and has only served to alienate the doctors, nurses, and healthcare workers whose commitment to India we need to foster. While there is no simple solution to this daunting challenge, responses from healthcare professionals themselves suggest that they need greater incentives to work in rural areas, including more resources and a pay grade that is commensurate with the important services they provide.