The lack of skilled health care providers in rural areas of India has emerged as the most important constraint in achieving universal health care. India has about 1.4 million medical practitioners, 74 percent of whom live in urban areas where they serve only 28 percent of the population, while the rural population remains largely underserved.
A new study indicates that the problem of uneven distribution of skilled health workers can be solved. Educational strategies and community health worker programs have shown promising results in India, according to the study.
The availability of doctors and nurses is limited by a lack of training colleges in Indian states with the greatest need as well as the reluctance of professionals from urban areas to work in rural areas. Initiatives under India’s National Rural Health Mission to reach out to the rural populations include an increase in sanctioned posts for public health facilities, financial incentives, workforce management policies, locality-specific recruitment and the creation of a new service cadre specifically for public sector employment. As a result, the National Rural Health Mission has added more than 82,343 skilled health workers to the public health workforce.
Before 2005, the most common strategy to reach out to rural populations was compulsory rural service bonds and mandatory rural service for preferential admission into post-graduate programs.
1. Sundararaman T, Gupta G. Indian approaches to retaining skilled health workers in rural areas. Bulletin of the World Health Organization 2011; 89: 73-77. (open access)