Parliamentary Standing Committee on Health and Family Welfare, 65th Report of the Committee on the proposal to introduce the Bachelor of Science (Community Health ) course in the country.
Majority of the Members being against the introduction of B.Sc(CH) course, the Committee recommends that the Government should not go ahead with the proposal for introduction of the course.
“But to meet the demand, graduates and post graduates in the AYUSH stream may be appointed in providing healthcare for rural people all over India“.
They also suggested that a one year training of AYUSH doctors to deal with common medical problems by posting them at District Hospitals may be mooted.
Also suggested Rural doctors course and one year bridge course for AYUSH doctors to prescribe allopathic medicines.
“Given the growing acceptance of alternate and complementary systems of health care as part of an expanded health service, the BPHP curriculum may combine essential and relevant elements of both allopathic and AYUSH systems. India may, thereby, be the first country to formally create an innovative fusion product of both systems at the MHP level. This complementarity is likely to be useful in primary health care. Studies conducted by PHFI’s researchers in Chhattisgarh indicated that the MHPs who have undergone training for 3 years were competent to handle a range of primary healthcare problems like the diagnosis and treatment of malaria, diarrhoea, hypertension and diabetes mellitus and demonstrated the same competency as medical officers in treating several medical conditions commonly seen in Primary Health Centres. The introduction of MHPs into India’s health system through a well-designed BPHP programme can increase the outreach and performance of the health system and strengthen primary health care in both rural and urban areas. He opined that the proposed move of the Government was not meant to provide second-rate care to rural population but strengthen and enable the delivery of primary care for all”.
“Even if MBBS doctors of the appropriate quality in sufficient numbers were produced, it would be impossible to keep them in public service in the rural areas”.
“India has a severe shortage of human resources for health. It has a shortage of qualified health workers and the work force is concentrated in urban areas. Bringing qualified health workers to rural, remote and under-served areas is very challenging. Many Indians, especially those living in rural areas, receive care from unqualified providers. The migration of qualified allopathic doctors and nurses is substantial and further strains the system. Nurses do not have much authority or say within the health system and the resources to train them are still inadequate. Little attention is paid during medical education to the medical and public health needs of the population, and the rapid privatization of medical and nursing education has implications for its quality and governance. Such issues are a result of under-investment in and poor governance of the health sector- two issues that the Government urgently needs to address.”
Three & half years BRHC course would produce inferior quality doctors who would lack credibility to lead the team of other health workers
Currently, vacancies in PHCs are very high. In some states and districts it could be as high as 40 percent. Informal vacancy or absenteeism is even higher. One study puts it at over 50 percent. The reasons for doctors not serving in rural areas are many.
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