February 21, 2010

India to turn out over 145,000 rural doctors

With people-doctor ratio six times lower in rural India in comparison to cities, the central government on Thursday said it will produce 145,000 rural doctors through a truncated medical course designed after the Chinese "barefoot doctors".

"The proposal envisages training persons from rural areas on the basis of merit to equip him or her to primarily, I underline, primarily to work in 145,000 sub centres," Health Minister Ghulam Nabi Azad said here.

Azad said the proposed Bachelor of Rural Medicine and Surgery (BRMS) course, nicknamed as rural MBBS, will be a community based solution to the public health challenges in rural areas.

This course will be of three-and-half-years as against the conventional of five years of training.

The 145,000 health sub-centres, the first medical treatment point for villagers, are now being manned by Auxiliary Nurse Midwives (ANM). Through rural MBBS course, the central government will deploy at least one doctor at these centres. They will also be appointed in some primary healthcare centres (PHCs) to assist the regular MBBS doctors.

He said not recognizing the need for trained medical human resources in rural areas and unwillingness to consider new ideas for addressing it will not help the situation.

There is a visible urban-rural dichotomy in healthcare delivery in India. While urban India has 200 doctors for every 100,000 population, the ratio is one sixth in rural areas.

"Barefoot doctors" in China are trained farmers who help healthcare reach villages where well qualified doctors will not like to settle down.

Though the rural MBBS is a much better system, the idea of rural healthcare through a special cadre was influenced by the Chinese model.

The minister told doctors associations and medical college authorities from all over the country that the course will not compromise the quality of rural health care. "We are not replacing MBBS or specialist doctors."

Emphasizing the importance of quality in medical education and value of trained medical doctors, Azad said huge vacancies in lower level medical delivery points and a surge in emerging diseases was forcing rural folks to visit cities and thus spend a lot of money. This can be stabilized at local level through rural doctors.

Due to physical, social and cultural distance from medical facilities, people tend to depend on unqualified quacks who often provide "irrational treatment". Azad said past neglect cannot be reason for not thinking of innovative solutions today.

"It is not our case to shirk away from responsibility of having trained doctors but idealism needs to be tempered with reality... the existing situation prevailing in rural areas is compelling us to look beyond current solutions," Azad asserted.

The minister also asked the Medical Council of India to put safeguards in place so there is no compromise in quality.

Link: Original Article

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