Lok Sabha Question No. 1992 (UNSTARRED), answered on 2021-02-12
Subject: Shortage of Doctors in Rural/Tribal Areas
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Navneet Ravi Rana

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1992 TO BE ANSWERED ON 12 TH FEBRUARY, 2021

## SHORTAGE OF DOCTORS IN RURAL/TRIBAL AREA S

## 1992.SHRIMATI NAVNEE T RAVI RANA:

Will the Minister of HEALTH AND FAMILY WE LFARE be pleased to state:

(a) whether there is acute shortage of doctors in remote/tribal areas of the country particularly in tribal areas of Amravati such as Chikhaldara and Dharni, if so, the details thereof;

(b) whether the doctors are reluctant to serve in such areas due to lack of proper facilities and i so, the reaction of the Government thereto;

- (c) whether the Government proposes to incentivize or provide other facilities to those doctors who arewilling to work in tribal areas and if so, the details thereof; and
- (d) the other steps taken to ensure that the sufficient number of doctors are deployed in tribal areas to serve the poor and tribal people?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(SHRI ASHWINI KUMAR CHOUBEY)

(a):  Public  Health  and  Hospitals  being  a  State  Subject,  the  primary  responsibili strengthening  public  healthcare  system  including  ensuring  availability  of  doctors  and human resources in public healthcare facilities including in remote / tribal a reas lies with the respective State Governments.

However, under National Health Mission (NHM), support is provided to the States /UT to strengthen their health care systems based on the proposals received from the States provide universal access to equitable, affordable and quality health care services all over country including in Tribal Areas, including ensuring availability of doctors in the rem tribal areas.

As per RHS 2019 data, the availability of doctors in PHCs in tribal areas is given at Annexure.

(b)  to  (d): Further,  under  NHM,  flexibility  is  given  to  the  States  for  providing  hard allowance, performance -based incentives, providing accommodation and transport facilities i rural  and  remote  areas,  sponsoring  training programmes,  etc  to  engage  human  resources  to address the issue of shortage of doctors and specialists in the public health facilities.

The  States  are  also  encouraged  to  adopt  flexible  norms  for  engaging  doctors  a specialists for public healthcare facilit ies. These include 'contracting in' and 'contracting out' of specialist services and engaging specialists outside the government system for service d at public facilities under NHM.

States  have  also  been  allowed  to  offer  negotiable  salaries  to  attra ct  doctors  and Specialists including flexibility in strategies such as ''You quote, we pay".

Further, the government has taken several measures to address the shortage of docto the  country.  The  government  has  increased  number  of  medical  colleges  and  s ubs quently increased MBSS seats. In last two years the number of Medical colleges have increased from (in 2018) to 562 (in 2020). Similarly, the number of UG seats have increased from 67,3 84,649 and PG seats have increased from 31,415 to 54,275 from 018 to 2020. Health being a State subject, recruitment and deployment of HR for the public health facilities is resp of the State Govt.

## Annexure

## : State wise availability of Doctors at PHCs in Tribal areas as per RHS 2019

| DOCTORS 2 AT PHCs IN TRIBAL AREA (As on 31st March, 2019)   | DOCTORS 2 AT PHCs IN TRIBAL AREA (As on 31st March, 2019)   | DOCTORS 2 AT PHCs IN TRIBAL AREA (As on 31st March, 2019)   | DOCTORS 2 AT PHCs IN TRIBAL AREA (As on 31st March, 2019)   | DOCTORS 2 AT PHCs IN TRIBAL AREA (As on 31st March, 2019)   | DOCTORS 2 AT PHCs IN TRIBAL AREA (As on 31st March, 2019)   | DOCTORS 2 AT PHCs IN TRIBAL AREA (As on 31st March, 2019)   |
|-------------------------------------------------------------|-------------------------------------------------------------|-------------------------------------------------------------|-------------------------------------------------------------|-------------------------------------------------------------|-------------------------------------------------------------|-------------------------------------------------------------|
| S.No.                                                       | State/UT                                                    | Required 1                                                  | Sanctione d                                                 | In Position                                                 | Vacant                                                      | Shortfall                                                   |
| 1                                                           |                                                             | [R]                                                         | [S]                                                         | [P]                                                         | [S-P]                                                       | [R-P]                                                       |
| 2 3                                                         | Andhra Pradesh Arunachal Pradesh # Assam                    | 153 143 181                                                 | 287 NA NA                                                   | 273 123 336                                                 | 14 NA NA                                                    | **                                                          |
|                                                             |                                                             |                                                             |                                                             | NA                                                          | NA                                                          | 20 **                                                       |
|                                                             |                                                             | NA                                                          | NA 409                                                      | 176                                                         | 233                                                         | NA 219                                                      |
| 4                                                           | Bihar Chhattisgarh Goa                                      | 395 8                                                       |                                                             | 18                                                          |                                                             |                                                             |
| 5 6 7                                                       |                                                             |                                                             |                                                             |                                                             |                                                             |                                                             |
|                                                             |                                                             |                                                             | 19 1030 NApp                                                |                                                             | 1                                                           | ** **                                                       |
|                                                             | Gujarat                                                     | 421 NApp 47                                                 | 67                                                          | 531 NApp 46                                                 | 499 NApp                                                    | NApp                                                        |
| 8 9                                                         | Haryana *                                                   |                                                             |                                                             |                                                             | 21                                                          | 1                                                           |
| 10                                                          | Himachal Pradesh Jammu &Kashmir Jharkhand                   |                                                             |                                                             |                                                             |                                                             |                                                             |
|                                                             | Karnataka                                                   | 48 192 64                                                   | 76 382                                                      | 75 240                                                      | 1 142 26                                                    | ** ** 26                                                    |
| 11                                                          |                                                             |                                                             |                                                             |                                                             | **                                                          | **                                                          |
| 12                                                          |                                                             |                                                             | 64                                                          | 38 232                                                      |                                                             |                                                             |
| 13                                                          | Kerala Madhya Pradesh Maharashtra                           | 137 338 467                                                 | 230                                                         |                                                             |                                                             |                                                             |
| 14                                                          |                                                             |                                                             | 364 740 NA                                                  | 289 666                                                     | 75                                                          | 49                                                          |
| 15 16                                                       |                                                             |                                                             |                                                             |                                                             | 74                                                          | **                                                          |
|                                                             | Manipur Meghalaya # Mizoram #                               | 55 118 69                                                   | NA NA                                                       | 77 149 62                                                   | NA                                                          | ** ** 7                                                     |
| 17 18 19                                                    |                                                             |                                                             |                                                             | 139                                                         | NA NA NA                                                    |                                                             |
|                                                             | Nagaland # Odisha                                           |                                                             |                                                             |                                                             |                                                             |                                                             |
|                                                             |                                                             | 131                                                         | NA                                                          |                                                             |                                                             | ** 120                                                      |
| 20 21 22                                                    |                                                             | 427 NApp 233                                                | 444 NApp 305                                                | 307 NApp 254                                                | 137 NApp                                                    | NApp                                                        |
|                                                             | Punjab * Rajasthan                                          | 13                                                          | NA                                                          | 21                                                          | 51 NA                                                       |                                                             |
|                                                             |                                                             |                                                             |                                                             |                                                             |                                                             | **                                                          |
| 23                                                          | Sikkim                                                      |                                                             |                                                             |                                                             |                                                             | **                                                          |
| 24 25 26                                                    | Tamil Nadu Telangana Tripura                                | 105                                                         | 190                                                         | 126                                                         |                                                             | ** ** **                                                    |
|                                                             |                                                             | 93 48 10                                                    | 211 NA 17                                                   | 186 133 10                                                  | 64 25 NA                                                    | 0                                                           |
|                                                             |                                                             |                                                             |                                                             |                                                             | 7                                                           |                                                             |
| 27 28                                                       | Uttarakhand Uttar Pradesh                                   | NA                                                          | NA                                                          |                                                             | NA                                                          |                                                             |
|                                                             |                                                             |                                                             |                                                             | NA                                                          |                                                             | NA                                                          |

29

West Bengal

300

410

352

58

**

30

36

A& N Islands

Puducherry  *

4

N App

9

N App

5

N App

|          |                                      | NApp   | NApp   | NApp 17   | NApp **   | NApp **   |
|----------|--------------------------------------|--------|--------|-----------|-----------|-----------|
| 31 32 33 | Chandigarh * D &NHaveli # Daman &Diu | 7 0    | 3 0    |           |           |           |
| 34       | Delhi                                | NApp   | NApp   | 0 NApp    | 0 NApp    | 0 NApp    |
|          | * Lakshadweep#                       |        |        |           |           |           |
| 35       |                                      | 4      | 8      | 8         | 0         | **        |

Notes : # States with predominently tribal areas NA: Data not Available.   ** Surplus. *: State / UT has no separate Tribal Area / Population 1 One per Primary Health Centre as per IPHS norms 2 Allopathic Doctors N App - Not applicable Figures includes data of PHCs and HWC-PHCs at tribal areas

4

N App

**

N App