New Delhi: The ratio of nurses to doctors in India is estimated at 1.7: 1, according to NSSO data, and the ratio of doctors to allied health workers in the WHO and The Report could be 1: 1, according to the Public Health Foundation of India. Although there was no standardized skill-mix ratio for different health workers, most OECDs reported about 3-4-4 nurses per physician in the country, the report said.


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The recommendation of the Indian High Level Expert Group (HLEG) for the nurse-doctor ratio in India stands at :: 1.

Moreover, there was a need to maintain a balance (proper skill-mixing) between doctors and associate health workers.


According to NSSO data, the doctor-to-nurse ratio in India is approximately 1.7: 1, higher in Punjab (6.4: 1) and Delhi (4.5: 1), even in Bihar, Jammu and Kashmir, and the report states that there is less than one nurse per doctor in Madhya Pradesh.

It recommended that India invest in human resources for health (HRH) to increase the number of active health workers and improve the skills-mix ratio, which requires investment in professional colleges and technical education.

Eligible health professionals in India need to be encouraged to join the labor market and ensure additional training and skills enhancement for those already employed but inadequately qualified health workers, the report said.

In addition to increasing the availability and availability of quality health workers by the general population, investing in HRH will strengthen the health system to deal with epidemic situations such as Kovid-19 and other epidemics.

It will lead to economic growth, increased participation of women in the labor market, formalization of the labor market and overall economic recovery, the study said.

The study presents an updated estimate on the stock and structure of health professionals and active health workers in the country.

The Periodic Labor Force Survey (PLFS) conducted by the National Health Workforce Account (NHWA) and the Periodic Labor Force Survey (PLFS) conducted by the National Sample Survey Office (NSSO 2017-18) on health professionals using the data, estimates a total of 5.7 million health workers. These include allopathic doctors (1.1 million), dentists (0.27 million), nurses (2.3 million), pharmacists (1.2 million) and traditional therapists (AYUSH 0.79 million).

However, the size of active health workers is estimated to be much lower (from NSSO 2017-18) (3.04 million), with allopathic doctors and nurses estimated at 0.78 million and 1.36 million, respectively.

“The right balance between the skill-mix ratio of health workers provides the best healthcare. In contrast to the skill-mix ratio with the concentration of doctors at the state level, there is an inefficient skill-mix between doctors and nurses and doctors and associates. Health professionals in most Indian states,” the report said.

The public sector is challenged by the high rate of vacancies in approved posts. Rural health statistics highlight this issue, the study said.

While the deficit for Community Health Center (CHC) specialists is the highest, India faces deficits across the state for various positions. A review of the consistently published reports of rural health statistics shows a slow but steady increase in the number of health providers across the country.

Recruitment barriers for various reasons, lawsuits against the recruitment process and premature departure from the system, vacancies are blamed for various reasons, the report said.

Increasing the number of health workers and increasing the right balance in the mix of skills requires the supply of health professionals. The supply side of health professionals is an important parameter in reaching the goal of minimum optimal concentration of health workers.

Analysis of health worker estimates provides an approximate concentration of skilled health professionals (doctors, nurses and midwives) per 10 000 population.

“Keeping the current growth rate, the required concentration of health workers will not be met yet as the country’s population grows and the number of health professionals will be balanced.

“Increasing supply to nurses by nearly 200 percent will improve physicians: the nurse ratio between 1: 1.5 and 2030. This will require a faster scale-up of nursing programs,” the report said.

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