Background <p>India faces a shortage of skilled health professionals (SHPs). There is limited research measuring SHP deficits in rural public health centres. We estimated the current and future SHP densities and deficits, along with costs for SHP scale-up to achieve Sustainable Development Goal (SDG) 2030 targets.</p> Methods <p>We used the number of SHPs (doctors, nurses, and midwives) at rural primary and community health centres from the Rural Health Statistics reports (2009–2019) to calculate average annual percentage changes (AAPCs) at national and state levels using JoinPoint regression. Using AAPC values, we projected SHP counts and estimated densities (per 10,000 people) for years until 2030. The projected deficits for 2030 were calculated for three target density thresholds, aligning with the Millennium and Sustainable Development Goals. For scale-up costs, a state-wise statistical average of salaries for SHP groups was calculated assuming a 5% annual increase in allowance.</p> Results <p>During 2009-19, SHP density grew annually by 2.59% (95% CI: 0.93–4.28). The national SHP density would increase from 8.85 SHPs per 10,000 in 2019 to 11.47 in 2030. In 2030, India is expected to have a deficit of 0.47–1.83&#xa0;million SHPs. The scale-up costs to cover these deficits would range from INR 1.46–4.96 trillion, about 15% of India’s government health spending.</p> Conclusion <p>At the current rate, Indian rural public health centres will not achieve the target SHP density by 2030. The costs for scaling up the recruitment and retention of rural SHPs are relatively small, making it feasible.</p>

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Scaling-up skilled health professionals in the rural Indian public health system: projections for 2030

  • Yash Jawale,
  • Siddhesh Zadey,
  • Varad Puntambekar,
  • Vedika Sharma,
  • Vidhi Wadhwani,
  • Rachit Sekhrajka,
  • Amit Sahu,
  • Nanditha Venkatesan,
  • Aatmika Nair,
  • Suraj Bhor,
  • Sweta Dubey,
  • Surabhi Dharmadhikari

摘要

Background

India faces a shortage of skilled health professionals (SHPs). There is limited research measuring SHP deficits in rural public health centres. We estimated the current and future SHP densities and deficits, along with costs for SHP scale-up to achieve Sustainable Development Goal (SDG) 2030 targets.

Methods

We used the number of SHPs (doctors, nurses, and midwives) at rural primary and community health centres from the Rural Health Statistics reports (2009–2019) to calculate average annual percentage changes (AAPCs) at national and state levels using JoinPoint regression. Using AAPC values, we projected SHP counts and estimated densities (per 10,000 people) for years until 2030. The projected deficits for 2030 were calculated for three target density thresholds, aligning with the Millennium and Sustainable Development Goals. For scale-up costs, a state-wise statistical average of salaries for SHP groups was calculated assuming a 5% annual increase in allowance.

Results

During 2009-19, SHP density grew annually by 2.59% (95% CI: 0.93–4.28). The national SHP density would increase from 8.85 SHPs per 10,000 in 2019 to 11.47 in 2030. In 2030, India is expected to have a deficit of 0.47–1.83 million SHPs. The scale-up costs to cover these deficits would range from INR 1.46–4.96 trillion, about 15% of India’s government health spending.

Conclusion

At the current rate, Indian rural public health centres will not achieve the target SHP density by 2030. The costs for scaling up the recruitment and retention of rural SHPs are relatively small, making it feasible.