Health workforce in India: assessment of availability, production and distribution

ABSTRACT

Background: India faces an acute shortage of health personnel. Together withinequalities in distribution of health workers, this shortfall impedes progress towardsachievement of the Millennium Development Goals. The aim of this study was toassess health‑workforce distribution, identify inequalities in health‑worker provisionand estimate the impact of this maldistribution on key health outcomes in India.Materials and Methods: Health‑workforce availability and production wereassessed by use of year‑end data for 2009 obtained from the Indian Ministry ofStatistics and Programme Implementation. Inequalities in the distribution of doctors,dentists, nurses and midwives were estimated by use of the Gini coefficient andthe relation between health‑worker density and selected health outcomes wasassessed by linear regression.Results: Inequalities in the availability of health workers exist in India. Certainstates are experiencing an acute shortage of health personnel. Inequalities inthe distribution of health workers are highest for doctors and dentists and have asignificant effect on health outcomes.Conclusion: Although the production of health workers has expanded greatlyin recent years, the problems of imbalances in their distribution persist. As Indiaseeks to achieve universal health coverage by 2020, the realization of this goalremains challenged by the current lack of availability and inequitable distributionof appropriately trained, motivated and supported health workers.