Lack of Specialized Practitioners in India: Rural Areas Suffer

Since 2014, Prime Minister Narendra Modi’s government has established more than a dozen medical institutes similar to AIIMS and plans to build at least one large hospital in each of India’s 761 districts. However, the shortage of doctors remains a significant challenge. According to the World Health Organization (WHO), the doctor-patient ratio in India has decreased from 1.2 doctors per 1,000 patients in 1991 to about 0.7 in 2020, while the WHO-recommended level is 1. In comparison, China, with a similar population to India, has a ratio of 2.4.

Increasing the Number of Doctors and Hospitals

The Indian government has been working to increase the number of doctors by creating more medical schools. The number of public hospitals, excluding specialized institutes, has grown by 9% since Modi took office. Additionally, the number of undergraduate medical seats in public and private institutions has almost doubled, from 51,348 to 101,043 between 2014 and March 2022. Nevertheless, over 3,000 doctor positions were vacant in 31 major federal hospitals in February 2022, and vacant nursing and support staff positions exceeded 21,000.

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Shortage of Specialized Care in Rural Areas

The lack of specialized care is particularly pronounced outside major cities. According to government data, as of March 2022, there was a shortage of nearly 80% of surgeons, physicians, gynecologists, and pediatricians in rural community health centers. Specialist doctors tend to go abroad or join the private sector in big cities, as they have been trained in tertiary care environments and may not be adequately skilled or in tune with rural conditions in low-resource settings, explains Dr. K. Srinath Reddy from the Public Health Foundation of India.

“There is a certain trust in big city hospitals and an environment that encourages people to seek increasingly specialized care,” says Dr. Vandana Prasad, a technical advisor at the nonprofit Public Health Resource Network.

Dr. Syed Ahmed, a resident doctor at AIIMS Delhi, believes that many cases could be treated at the primary care level, but the trust in big city hospitals and the pursuit of specialized care largely explain the high number of patients and crowds outside hospitals.