In rural Odisha, the vacancies of doctors and specialists at Primary Healthcare Centres (PHCs) and Community Healthcare Centres (CHCs) touched an all-time high in 2016. Consequently, the doctor- to-population ratio in the rural areas stood at a high of 1:13,154 against the State average of around 1:2323. The national average stood at around 1:1668.
The reason of high gap behind the rural doctor-population ratio in Odisha vis-a-vis the whole State average reveals the higher doctor density in urban areas that included doctors in private hospitals and clinics. According to the State Medical Council, Odisha currently has around 19,000 registered doctors. But doctors in the Government-run health centres, including medical college hospitals, stood at a mere over 3,500, revealed the data.
It is not that the State is facing any acute shortage because, given the doctors produced by medical colleges in the State every year along with the sustained strength of doctors working minus the annual retirees put a conservative estimate about the total availability of doctors in 2016 at around 8,500. But the number of doctors working in State-run facilities is below 4,000. Here lies the challenge for the Government.
According to the World Health Organisation (WHO) norm, at least one doctor should cater to a population of 3,500, and by this yardstick, Odisha records a shortfall in the range of 65 per cent to 85 per cent of the required doctors in all 30 districts. A conservative estimate shows that State-run health centres need a whopping around 9,200 doctors against the current in-position strength of little over 2,000 in rural areas.
Now, consider how 2016 has fared the worst since 2013. The State’s PHCs and CHCs in 2013 had in-position strength of doctors and specialists totalling 1,335. But the in-position strength of doctors and specialists in 2016 dipped to around 1,313 only. Significantly, carrots doled by Government to doctors for taking up a posting in rural areas apparently failed to click since as many as 49 doctors deserted the PHCs last year. The result: allopathic doctors’ vacancy at the PHCs zoomed to a high of 353.
Interesting enough is that though the vacancies of specialists at the CHCs have fallen since 2013 but the vacancy still stood at a high of 554 in 2016, up from 552 in 2015, reveals the data available in State Health Directorate. The data also reveal the Government’s recent claim of increasing doctors at the CHCs as it shows recruitment of more general duty medical officers than specialists at the CHCs because against the sanctioned strength of 422 general medical officers, the CHCs have over 270 more such officers. With this lopsided placement of doctors in tehsils, the State sees a trigger in high-emergency patient load at the District Headquarters Hospitals (DHHs) and higher mortality rates at tertiary health centres.