Many healthcare facilities suffer from inadequate infrastructure, including insufficient diagnostic tools, hospital beds, and medical supplies. Poor management, corruption, and fraud in health programs worsen inefficiencies, eroding public trust and hindering effective healthcare delivery
Published Dec 30, 2024 | 7:00 AM ⚊ Updated Jan 04, 2025 | 9:40 AM
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While the South Indian states boast about the availability of number doctors, medical colleges, hospitals, spending to health and its related health infrastructure, the recent Reserve Bank of India(RBI), ‘Handbook of Statistics on Indian States’ showcases a different story of availability of specialist doctors in secondary healthcare infrastructures.
The scenario at Community Health Centres (CHCs), which require specialists in fields such as surgery, obstetrics and gynecology, pediatrics, and general medicine, paints a bleaker picture. None of the South Indian states meet their specialist requirements.
The shortage of specialists at CHCs compromises secondary and tertiary care services. Specialists in surgery, obstetrics and gynecology, pediatrics, and general medicine are crucial for addressing complex medical needs for rural populations which ensure comprehensive and specific healthcare in need, but their scarcity hinders the system’s ability to meet these demands effectively.
According to an RBI report, Tamil Nadu faces the largest shortfall, requiring 1,540 specialists but having only 227 in position, leaving a deficit of 1,313. Whereas Karnataka, reports a shortfall of 455 specialists, with just 273 in position against a requirement of 728.
Even Kerala, with one of the best health infrastructure as per as western countries, also faces the shortage. The state requires 844 specialists but has only 56 in position, resulting in a shortfall of 788.
The Telugu state of Telangana’s shortfall stands at 79 specialists, with 37 in position against a requirement of 116, whereas its counterpart Andhra Pradesh fares better comparatively, with a shortfall of 49 specialists, having 503 in position for a requirement of 552.
Primary Health Centres (PHCs) serve as the first point of contact for rural healthcare in India. In the South, Tamil Nadu, Kerala, and Telangana stand out with surpluses in doctors at PHCs.
For instance, Tamil Nadu with 2,594 doctors in position against a requirement of 1,419, has a surplus of 340 doctors. Kerala also mirrors this trend with 1,525 doctors in position for a requirement of 780, resulting in a surplus of 84. Similarly, Telangana has 757 doctors for a requirement of 594, indicating a surplus of 431.
In contrast, Karnataka and Andhra Pradesh, while faring better than many other parts of India, report shortfalls. Karnataka has a modest shortfall of 80 doctors against a requirement of 2,132, while Andhra Pradesh records a negligible deficit, with just 20 positions unfilled.
The trend of surplus PHC doctors, and shortage of CHCs doctors observed in South India reflect a microcosm of the national scenario. Across India, PHCs require 25,354 doctors, of which 32,901 are in position, leaving a surplus in some states. However, the picture changes dramatically for CHCs, where the requirement of 21,964 specialists contrasts sharply with only 4,413 in position, resulting in a shortfall of 17,551 specialists nationwide.
It should be noted that according to data from the National Medical Commission (NMC), Tamil Nadu has the second-highest number of doctors in the country, with 1,49,399 registered with the Tamil Nadu Medical Council (TNMC). The Karnataka Medical Council (KMC) has 1,41,154 registered doctors. The Travancore Medical Council, responsible for registering medical practitioners in Kerala, has 73,069 doctors.
It is noteworthy that the Andhra Pradesh Medical Council has 1,05,805 registered doctors, while the Telangana Medical Council has the lowest registration among southern states, with 26,411 doctors.
Southern states also demonstrate a better doctor-patient ratio compared to other parts of the country. Karnataka has one of the highest ratios, with one doctor for every 457 patients (1:457), while Tamil Nadu has a ratio of 1:495. Andhra Pradesh has a ratio of 1:488, and Kerala has a ratio of 1:509.
In contrast, Telangana has a doctor-patient ratio of 1:1,452. According to TGMC officials, most doctors practising in Telangana are registered with the Andhra Pradesh Medical Council (APMC). If the populations and doctor numbers of both states are combined, the former united Andhra Pradesh would have a doctor-patient ratio of 1:681.
The distribution of healthcare professionals in India is highly uneven, with doctors concentrated in urban centres. This disparity leads to significant gaps in access to healthcare services, particularly in underserved areas where many primary health centres (PHCs) remain under-resourced and understaffed.
The quality of healthcare services also varies widely. Despite the number of doctors, there is a notable shortage of specialists, especially in rural areas. Approximately 70 percent of specialist positions in community health centres are vacant.
Additionally, many healthcare facilities lack the necessary infrastructure and equipment to provide comprehensive care. This includes inadequate diagnostic facilities, insufficient hospital beds, and a shortage of essential medical supplies.
Poor management practices and corruption within the healthcare system contribute to inefficiencies and the misallocation of resources. Allegations of fraud in health programs have been reported, further eroding public trust and hindering effective healthcare delivery.
Many doctors prefer to practise in urban settings due to better career opportunities, lifestyle amenities, and higher salaries, besides the availability of the necessary infrastructure to work effectively. This trend exacerbates the shortage of healthcare providers in rural areas.
Once doctors are placed in rural areas, retaining them becomes a challenge. Factors such as limited professional growth opportunities, inadequate living conditions, and lack of support systems contribute to high turnover rates among healthcare professionals in these regions.
Rural areas often face socioeconomic challenges, including poverty and lower educational levels, which can hinder the recruitment and retention of qualified healthcare professionals. These factors also affect the health-seeking behaviour of the population, further complicating healthcare delivery.
(Edited by Ananya Rao)
