Context: According to India’s first comprehensive assessment of public and private health care availability and quality, at least two of every three doctors in rural India are informal providers of care, with no qualifications in modern system of medicine.
Issue

• The health pandemic has exposed India’s woefully inadequate health infrastructure.
• The combined public health expenditure of States and the central government in India is a mere 1.5% of GDP, compared to China’s at 3% and America’s at 9%.
• With COVID-19 expected to linger on until a suitable vaccine is available at large, there is no option other than to significantly ramp up India’s health expenditure.
• Many public health experts are of the opinion that the central government will need additional funds of the equivalent of at least one percentage point of GDP to continue the fight against COVID-19.

Key Points

• The survey of 1,519 villages across 19 states was done in 2009 by researchers from the Centre for Policy Research (CPR) in New Delhi.
• Seventy five percent of Indian villages have at least one health care provider and a village on average has three primary health providers.
• However, 86% of them are private doctors and 68% have no formal medical training.
• The study found that formal qualifications were not a predictor of quality, with the medical knowledge of informal providers in Tamil Nadu and Karnataka being higher than that of trained doctors in Bihar and Uttar Pradesh.
• For the vast majority of rural households, informal providers–usually called quacks– are the only option that is locally available.
• The share of informal providers did not decline with rising socioeconomic status, though the quality of doctors improved.
• The informal providers account for 68% of the total provider population in rural India, with 24% of them being Ayush doctors practising traditional and alternative stems of medicine and only 8% having an MBBS degree.

Report by WHO: As per the World Health Organization’s 2016 report on ‘The Health Workforce in India’, 57.3% people practising allopathic medicine in India did not have a medical qualification, and 31.4% were educated only up to secondary school level.