There is a shortage of SHPs (skilled health professionals) in India. Limited research has been conducted to emphasise on this shortage.
Beyond availability, the contrasting distribution of SHPs across public vs private healthcare sectors and rural vs urban regions is a concerning find. Over 80% of doctors and 70% of nurses work in the private sector and this accounts for less than 50% of the patient population. In fact, two-thirds of Indians reside in the rural areas. The proportion of doctors practising in the rural areas of India have gone down from 34.5% in 2011 to 27.4% in 2017.
When a patient is exposed to a circumstance such as a limited access to SHPs, they are compelled to travel long distances, often this leads to them missing out on a day’s wage and ultimately turn dependent on the out-of-pocket incuring costs on healthcare and transportation.
This case holds true even for most of the primary and secondary healthcare services.
While the current analysis focuses primarily on the shortage, it is important to note that beyond the availability of SHPs, their knowledge, skills, and acceptability to the local population, and supporting infrastructure (e.g., diagnostics/lab services, essential drugs, etc.) determine the capacity and quality of healthcare provided. The Government of India launched the NRHM (National Rural Health Mission) to counteract this in 2009. This was subsumed under the NHM (National Health Mission). The mission’s aim was to expand primary and secondary level care by establishing and upgrading multiple centres based up on a referral hierarchy.
The operational guidelines for these centres are followed by the IPHS (Indian Public Health Standards). In 2030, India is expected to have a deficit of 0.47-1.83 million SHPs. The scale-up costs to cover these deficits would range from INR 1.46-4.96 trillion which is about 15% of the total government’s health funding.
There is an insufficiency when it comes to research on the measurement of the SHP density in the rural areas. There is also unfortunately, no evidence of progress over the years nor a chance of achieving the target by 2030 or even when it comes to the financial support and encouragement required to achieve these targets.
Under a realistic scenario, a growth rate of 2.59% rural SHPs were projected to increase from 364,271 in 2019 to 420,955 in 2030 on a national scale. The rural SHP density will grow to 11.46 per 10,000 people in 2030. The UT of Daman and Diu was projected to have the highest rural SHP density of 136.12, while Himachal Pradesh would have the lowest density of 5.39. The rural SHPs were projected to reach 482,643 in 2030.
Multiple barriers exist to recruit and retain SHPs, particularly doctors, in the rural healthcare centres. These include inadequate salaries and bureaucratic delays in the release of funds, the neglected infrastructure in the rural public health system, the poor roadway networks that limit access to the ‘outside’ world, the lack of opportunities for future education and career development, and the negligible resources for supporting families, including children, among many others.[4,36,37]
To reach the rural SHP density thresholds, the Central and State Governments in India need to make recruiting and retaining SHPs in the rural areas a priority. Analysis of the 1983, 2002, and 2017 National Health Policies – the apex health policy documents for India – noted a growing focus on the rural-urban disparities in the SHP distribution over the years.[38] The study also found no increase in rural SHP density relative to urban SHP density from 1981 to 2011, justifying the need for increased policy focus.
Credit and Source;
Jawale, Y., Zadey, S., Puntambekar, V. et al. Scaling-up skilled health professionals in the rural Indian public health system: projections for 2030. BMC Health Serv Res (2026). https://doi.org/10.1186/s12913-026-14550-x
Rural India is struggling with shortage of doctors, paramedical staff – The HinduBusinessLine https://share.google/fHyA7agEF8eRhYnTX
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