Make rural health jobs more alluring

Rural Health Statistics 2021-22 presents a dismal picture of India’s state of healthcare. Community healthcare centres (CHC) have a staggering paucity of medical staff — 83% shortage of surgeons, 82% of paediatricians and 79% of general physicians. Operation theatres, X-ray facilities and laboratories remainnon-functional as required facilities and personnel are missing for the most part. This is truly a scandal in a country aiming first-world credentials one day. A functioning healthcare system requires infrastructure and facilities, qualified personnel — doctors, nurses, support staff — and regular medical supplies. On each count, the rural health system fails spectacularly. If India is serious about reaping the demographic dividend, it must invest in building and maintaining a robust healthcare system in the much patronised ‘Bharat’ tracts of India.

The three-tier system — health sub-centres (SC), primary healthcare centres (PHC) and CHCs — is characterised by paucity and absenteeism. Ensuring that each level of healthcare is staffed will require providing incentives, making it a condition of admission, or a requirement to access freeships and scholarships. All SCs and PHCs have a general practitioner, auxiliary nurse/midwife and healthcare worker. But even on paper, these are understaffed.

More funds, though necessary, are not sufficient alone to fix the problem. A functioning system with strong accountabilities is required to ensure appointed medical staff actually do their job. Fixing this extreme rural-urban disparity will require incentives to get doctors, nurses and technical staff to sign up. A programme that gives a 4-5-year employment contract to young medical graduates and newly retired health practitioners could get healthcare staff to serve in rural areas. Getting teaching hospitals in districts to serve the rural centres is another nudge.