Daily Newsings: 24 April 2025
India needs more healthcare workers
Daily Newsings are musings on the daily news.
The Karnataka Government has requested the National Medical Council to increase the number of undergraduate medical seats in the country. Karnataka's minister for medical education and skill development, Sharan Prakash Patil said that there is a huge disparity between the number of students applying to be doctors and the number of seats that are available. He also alluded to the high demand for Indian healthcare professionals not just in India but in different countries as well.
Currently there are around 1.2 lakh MBBS seats in the country.1 Compare this number to the number of students who applied for the NEET examinations this year -- around 24 lakh.2
Here is a simple fact: India needs a lot more healthcare professionals. The Indian government claims that it has achieved the ratio of doctors to population as recommended by the WHO. The WHO recommends a ratio of 1:1000, where there is 1 doctor for every 1000 people in the population. And according to the Union Government, this number has been achieved.
However, the methodology of arriving at that number seems to be problematic. According to the Periodic Labour Force Survey 2017-18 of the National Sample Survey Office (NSSO), the number of doctors actively practicing in the country might be much lower than the Government's numbers. According to a paper published in the journal Human Resources for Health in 20213, the discrepancy might be due to a few different reasons:
The Government datasets may not be constantly updated to reflect healthcare workers who leave the country to work in other countries
Many professionals who have moved states may register there also and there may be double counting in the numbers
Councils in India don't require renewal of registrations, and thus the names of professionals who have left the workforce due to death, retirement, or other family circumstances, might still be counted
Moreover, the paper also points out that there is a shortage of nurses in the country. The ratio of nurses to doctors is less than 2:1 in the country. For a reference number, most developed nations in the world have a proportion of 3-4 nurses for every doctor. The paper found that although the total number of nurses in the country is more than 3 times that of doctors, most of the nurses are not currently working in India. They have either moved out of the country or have stopped working due to family circumstances.
All that to say, India needs a lot more healthcare professionals. From doctors to nurses to other allied health professionals.
India's healthcare woes do not merely end with the total availability of healthcare workers though. The distribution of healthcare workers is also extremely skewed, both between states and between urban and rural areas. While there are more than 25 doctors per 10,000 people in Kerala, there are less than 3 doctors for every 10,000 people in Odisha. Nearly two-thirds of all healthcare professionals are congregated in urban areas, whereas only one-third of India's population resides in urban areas.
It would be definitely good for the Government to increase the number of seats in medical, nursing and allied healthcare professions. While quality does need to be maintained, it is difficult to argue that one student who got a 610 is more qualified to be a doctor than a student who might have achieved a score of 609. Various factors play into scores, and not all of them are connected to the potential of the student to become a good doctor.
But the Government's response cannot end with increasing the number of seats. Policy changes need to be enacted such that working conditions for women (who constitute the large numbers of nurses) are improved so they are enabled to keep working if they so desire. Policy changes and investment into healthcare also needs to incentivize healthcare professionals moving into rural areas and places with less healthcare available.
As Christians, healthcare is an area where we can have a wartime mentality, to use John Piper's language. Like in a wartime, we encourage more young people to join the forces fighting the darkness of sickness and death. This involves hard work and gruelling preparation both before and after joining medical colleges. Since this is wartime, we encourage young healthcare professionals to serve in the frontlines where the need is high. For example, most mission hospitals such as those run by Emmanuel Hospital Association (EHA) are understaffed. Like trench-warfare, living in such rural areas will not be easy. But there is a need.
At the same time, like in a wartime, Christians do not despise the role of support teams such as research and training teams. We do not say that all Christian healthcare workers need to be in the frontlines. Wars are not just won by soldiers in the frontlines. Wars are also won through the hard work of research teams (through their development of advanced technology) who might be in urban areas. For Christians, support work involves praying for healthcare workers, hospitals and the sick in the country. It involves training young children to aspire to serve, and funding the work of organisations involved in healthcare through the sacrificial living of her members.
The church's primary task is gospel proclamation. But as the members of the church grow more into Christ-likeness, they increasingly see the entirety of their lives, including their vocations, as avenues to sacrificially serve others, rather than seeing the world as opportunities to serve self with more wealth, security or better standards of living. As Christians see Jesus more and more, they begin to imitate Jesus in moving towards brokenness and need rather than towards comfort and plenty.
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Cheers,
Caleb
https://medicaldialogues.in/health-news/nmc/nmc-data-shows-karnataka-topping-mbbs-seats-up-with-most-medical-colleges-146130
https://www.business-standard.com/education/news/neet-ug-2024-25-record-24-lakh-applications-received-from-candidates-124032100380_1.html
Karan, Anup, et al. "Size, composition and distribution of health workforce in India: why, and where to invest?." _Human resources for health_ 19 (2021): 1-14. https://link.springer.com/content/pdf/10.1186/s12960-021-00575-2.pdf