The end of the decade will witness a massive shortage of healthcare workers, according to the report launched in the run-up to the World Economic Forum (WEF) 2023. The report titled ‘Global Health and Healthcare Strategic Outlook’ stated that the shortage could rise to 10 million all around the globe. Commenting on the reason for the same, WEF said, “COVID-19 put extra strain on healthcare systems, disrupted global supply chains of essential products and pushed overburdened care providers to breaking point”. Furthermore, the report said the increase in investments in the healthcare sector did fast-track the progress in telehealth, precision medicine and vaccines but failed to address the issues of worker burnout.
India has observed a steep decline in healthcare workers since the pre-pandemic era. In 2019, the Ministry of Health and Family Welfare informed that against WHO’s recommended number of one doctor for every thousand people, India had one doctor for every 1457 people. There were 1.7 nurses for every thousand people, while the recommended ratio was three nurses per thousand people. WHO recommended three beds per thousand people, while India had one bed for 2,239 people. These perturbing figures put a strain on public healthcare delivery, especially in rural areas where the shortage of healthcare staff is seriously acute. According to the Rural Health Statistics 2021-2022, there is an 80% shortfall in paediatricians and surgeons and more than 70% paucity in physicians, obstetricians and gynaecologists in these areas. India’s high infant and maternal mortality rates can be primarily attributed to the scarcity of medical carers in remote areas.
The shortage hit badly when the COVID-19 pandemic struck India in 2020. Apart from facing a crunch in the number of doctors and nurses, there was a shortage of community health workers and paramedic staff to conduct surveillance activities, mass testing and contact tracing. In addition, there was a shortage of resources such as personal protection equipment, oxygen cylinders and ambulances as well. “The threat of violence and burnout are real and is one of the contributors as to why doctors are considering other professions,” said Kashish Malhotra, Physician from the Department of Internal Medicine, Dayanand Medical College and Hospital.
India witnessed substantial improvement in the health status of its population during the last 75 years post-independence. However, the COVID-19 pandemic overwhelmed the already stretched Indian health systems, reversing some of the gains made in the past several decades. Moving forward, the government needs to address the shortfall in the healthcare system on a priority basis. The health system needs to be strong enough to stand against the long-term consequences of the pandemic as well as be prepared for similar future health emergencies. We also need to ensure that our response to emergencies such as the COVID-19 does not come at the cost of other essential health services. We must adopt innovative strategies that go beyond a conventional health sector response and recognize health literacy promotion as an integral component of healthcare.