Healthcare by non-doctors an underused resource: Public Health Foundation of India

Even though the health sector employs five million workers in India, the skilled health professional density of the country is much lower than in other countries, revealed a recent talk organised by the Public Health Foundation of India on 'Healthcare by Non-Doctors: An Underused Resource'.

As per the World Health Organization, India is among the countries with a critical shortage of 'skilled' healthcare providers with a 20.7 Human Resource for Health (HRH) as compared to the 22.8 HRH threshold per 10,000.

As per the government data available, India had 19,80,536 registered nurses and registered midwives (RNRM), 8,41,279 ANMs, and 56,367 lady health visitors until January 2016. But with the merging of nursing and midwifery, when the ANMs graduate, they are expected to perform routine nursing tasks and some basic midwifery, mostly under doctors' supervision.

Despite the underutilisation of these trained non-doctors, data reveals that the midwife-led continuity models of care have shown tremendous results. In all, 15 such trials involving 17,674 women showed that women who received midwife care were less likely to have an epidural (pain-relief injection during labour, includes steroids and anaesthetics) and preterm birth. They were also at a lower risk of losing their babies.

The WHO recommendation on midwife-led continuity of care during pregnancy states, "Midwife-led continuity-of-care models, in which a known midwife or a small group of known midwives, supports a woman throughout the antenatal, intrapartum, and postnatal continuum, are recommended for pregnant women in settings with well-functioning midwifery programmes."

"There are several severe health workforce challenges in India and to deliver a strong programme of primary healthcare-led Universal Health Coverage by 2030, we need to better utilise our non-doctors healthcare providers and upgrade current Primary Health Care Centers and sub-centres to Health and Wellness Centers, which will employ more healthcare workers," said Dr K Srinath Reddy, President, Public Health Foundation of India.