RHS Report States At Least 80% Shortfall of Specialists in CHCs

New Delhi: The Rural Health Statistics (RHS) report published by the Ministry of Health and Family Welfare on January 12 reveals that India is reeling under an acute shortage of specialist doctors, with a shortfall of nearly 80% of the required specialists at Community Health Centres (CHCs). 

According to a report in The Hindu, the RHS report points out that there is a shortfall of specialist doctors, including surgeons (83.2%), obstetricians and gynaecologists (74.2%), physicians (79.1%) and paediatricians (81.6%). 

Overall, there is a shortage of 79.5% of specialists at the CHCs as compared to the requirement. Simply put, it means that against 10 specialists needed to man CHCs in villages, only two are available.

What are CHCs?

CHCs which constitute the secondary level of health care were designed to provide referral as well as specialist health care to the rural population. Indian Public Health Standards (IPHS) for CHCs were first released under National Rural Health Mission (NRHM) in early 2007 and are mandated to provide specialised medical care of surgeons, obstetricians, gynaecologists, physicians and paediatricians to the village population. 

CHCs are being established and maintained by the State government under Minimum Needs Programme (MNP)/ Basic Minimum Services (BMS) Programme.

As per minimum norms, a CHC is required to be manned by four medical specialists i.e. surgeon, physician, gynaecologist and paediatrician supported by 21 paramedical and other staff. It has 30 in-door beds with one Operation Theatre (OT), X-ray, labour room and laboratory facilities. The idea of a CHC is to serve as a referral centre for Primary Health Centres (PHCs) and to also provide facilities for obstetric care and specialist consultations.

RHS Report 21-22

As per the report in The Hindu which published the findings of the RHS report, there are 6,064 CHCs across India and the Health Ministry has been unsuccessful in meeting the requirement for specialist doctors in most of these centres. 

The current position of specialists at the CHCs reveals that as of March 31, 2022, of the sanctioned posts, 71.9 % of surgeons, 63% of obstetricians and gynaecologists, 67.5% of physicians and 69.7% of paediatricians are vacant. Overall 67.8% of the sanctioned posts of specialists at the CHCs are vacant. Importantly, there has been no change in the specialist shortfall between 2021 and 2022 with the shortage percentage being almost the same – 79.9% in 2021 and 79.5 % in 2022.

The RHS report states that this is despite the fact that, in 2005, the number of specialist doctors in CHCs was 3,550- a 25% increase to 4,485 in 2022. However, with the number of CHCs growing, the requirement for specialist doctors required to make the centres functional has also increased. 

“Requirements of specialist doctors in CHCs has increased by 63.8%, whereas there is only an increase of 26.3% in the actual number of in-position specialists,” the report notes. 

The report also recommends that nursing orderlies be trained in the assistive procedures required for surgery and funds be provided for outsourcing and providing support services according to the need of each centre, 

“Apart from specialist doctors, there is also a shortage of female health workers and auxiliary nursing midwives, with upto 14.4% of these posts lying vacant in primary health centres and sub-centres,” The Hindu reported.