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While Uttar Pradesh (UP) chief minister Yogi Adityanath said the state needs 500,000 doctors, the immediate need would be 199,281 doctors--39.8% of what the CM claimed--to meet the World Health Organization (WHO) standard of one doctor per 1,000 population and improve some health indicators that are the worst in the country.

UP, with a population of 199 million or almost equal to Brazil, had 65,343 registered doctors with medical qualifications, according to the 2015 National Health Profile. Assuming 80% are on duty (a view taken by a Parliamentary committee on health and family welfare), 52,274 doctors actually practice in the state. So, each doctor is serving 3,812 patients--more than three times the WHO standard.

To meet the WHO standard, UP would need to add at least 146,726 doctors.

UP has the worst infant mortality rate (infant deaths per 1,000 live births) and under-five mortality rate (deaths of children under five per 1,000 live births) in the country, comparable to many poorer African countries, IndiaSpend reported on March 16, 2017.

More doctors per 1,000 population, better the health outcomes

States with doctor-population ratio closer to the WHO standard had lower IMR and under-five mortality rate, according to a FactChecker analysis of the 2015 National Health Profile data on the number of registered doctors and the National Family Health Survey, 2015-16.

Karnataka had one doctor per 754 citizens--the best among the ten populous states analysed--and an IMR of 28 and under-five mortality rate of 32, which was better than the all-India IMR of 41 and under-five mortality rate of 50.

Andhra Pradesh, Tamil Nadu and Maharashtra, which had doctor-to-population ratio better than the WHO standard, showed similar trends.

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Source: National Health Profile 2015, National Family Health Survey, 2015-16

UP, which had one doctor per 3,812 people--the worst among the ten states--also had the worst IMR (64) and under-five mortality (78) in the country.

Increasing the number of physicians by one per 1,000 population reduced IMR by 15% within five years and by 45% in the long-run, according to this 2009 paper from the Harvard School of Public Health.

Many positions vacant in rural areas

UP has the highest vacancies (24%) for medical officers and the second highest (20%) vacancies for specialists in rural areas, according to Rural Health Statistics, 2015.

Of 3,497 positions for doctors in primary health centres in UP, 2,300 were vacant--a shortfall of 1,288 or 36%.

Of 3,092 specialists required at community health centres, including paediatricians, gynaecologists, surgeons and physicians, 1,615 were vacant--a shortfall of 2,608 or 84%.

India’s doctor-patient ratio 70% less than US, 75% less than Argentina

For a population of 1.2 billion, India has 929,000 doctors registered in the Indian Medical register, with 740,000 active doctors and a ratio of 1 doctor per 1,674 people, 75% lower than Argentina and 70% lower than the US, IndiaSpend reported on November 16, 2016.

The problem is worse in the government sector since only around 100,000 allopathic doctors work there, and every doctor serves 11,528 people.

India would need 500,000 more doctors to reach the WHO norm of 1 doctor per 1,000 population, IndiaSpend reported on September 1, 2016.

Very few trained doctors in UP

For 16.5% of India’s population living in UP, the state has 16.6% of allopathic doctors in India, according to WHO’s 2016 Health Workforce in India report.

Having allopathic practitioners isn’t enough: The report said only 18.4% had any medical training while 56.6% “doctors” had completed only secondary education.

There is more evidence to show that UP lacks trained medical professionals: Of 200,000 doctors added in India between 2008 and 2014, the state added just 13,365 doctors or 6% of the total, IndiaSpend reported on November 16, 2016.

So, UP needs more doctors--199,281 to be exact--but doctors who are medically trained and who are ready to serve in the rural posts.

The first task for the CM should be add nearly 150,000 doctors to meet the WHO standard; adding 450,000 more doctors, as he claimed UP needs, will lead to doctor-population ratio of 1:400, which is almost at par with the US.

(Yadavar is principal correspondent with IndiaSpend & FactChecker.)

Swagata Yadavar