The Indian authorities usually cites the World Well being Group (WHO)’s “benchmark” of 1 physician for each 1,000 individuals. Nonetheless, this isn’t a regular formally prescribed by the WHO.
Parliament Query and Reply information present that till at the very least 2010, the federal government maintained that the WHO had not prescribed any particular commonplace for the doctor-population ratio. However solutions from 2015 and as just lately as 2024 present in any other caseReplies in each these years cite the 1:1,000 ratio,
In each replies, the federal government used this benchmark to check physician availability in India. Since relying solely on registered allopathic docs pushed the physician–inhabitants ratio above the 1:1,000 benchmark, the federal government opted to incorporate AYUSH practitioners as effectively, decreasing the ultimate ratio. Notably, whereas calculating the ratio for allopathic docs, the federal government used solely 80% of them, as solely this proportion may be thought-about “out there”. Nonetheless, when it got here to AYUSH docs, they didn’t apply the provision issue.
The beneath chart exhibits these doctor-population ratio calculations sourced from numerous Lok Sabha and Rajya Sabha replies.
Setting these discrepancies apart, the ratio itself is questionable. The WHO, in a written response to The Hinduclarified that it “doesn’t present suggestions for well being employee inhabitants ratios at nation degree”. The company doesn’t make such suggestions as a result of ratios must be decided based mostly on a rustic’s well being labor market dynamics and particular person wants, it stated.
Many consultants have confirmed this. “There has by no means been any norm by the WHO for the doctor-population ratio,” stated public well being professional Dr. Chandrakant Lahariya, a former workers member of the WHO. The quantity, he defined, was initially referenced as a WHO-recommended norm in some educational papers with out attribution to any supply inside the WHO. Subsequently, it was cross-cited with out verification and utilized by Parliament in its responses too.
Dr. Kiran Kumbhar, a public well being professional and a historian of medication and healthcare in India, stated that there’s “completely no indication wherever within the WHO’s paperwork about this advice”. In keeping with Dr. Kumbhar’s article in The India Discussion boardthe earliest official reference to the 1:1,000 determine seems within the Medical Council of India’s ‘Imaginative and prescient 2015’ report, launched in 2011. The doc acknowledged, based mostly on professional consultations, that the focused physician inhabitants ratio could be 1:1,000 and projected that India might attain this by 2031.
Whereas the WHO didn’t check with the 1:1,000 ratio in its response, the worldwide physique acknowledged that there are some world benchmarks used to observe world well being employee wants, such because the Sustainable Improvement Targets (SDG) composite index threshold, which is the newest one. “It consists of the estimated variety of expert well being staff wanted to achieve the minimal proportion of feat of excessive protection, outlined as 80% or above for 12 chosen well being indicators linked to the SDGs,” the WHO defined. The most recent determine for that benchmark is 4.45 docs, nurses, and midwives per 1,000 inhabitants, it stated.
Well being programs researcher Siddhesh Zadey, co-founder of the Affiliation for Socially Relevant Analysis India, defined the origins of this composite determine. “First, in 2006, they stated the minimal quantity must be 2.25 per 1,000 after which revised it to 4.45 later,” he stated. Mr. Zadey defined that many misrepresented the composite determine, assuming that inside it, a particular portion could be docs and the remaining nurses and midwives. “Nonetheless, the WHO was clear that the mixed group needed to be 2.25; they by no means acknowledged that inside that, there’s a particular distribution,” he stated.
Mr. Zadey argued that separate figures for docs are sometimes cited to justify the necessity for extra medical schools. “Within the final 10 years, we’ve seen that this quantity has turn out to be political. It’s being weaponised by the AYUSH facet of well being workforce, which is pitching that the goal may be reached if they’re included,” he stated.
Dr. Lahariya argued that whereas composite figures are helpful in assessing the general efficiency, these have restricted relevance as a result of there’s unequal distribution. “Inside a rustic, there may be States which have achieved various ratios per thousand inhabitants,” he stated.
The WHO response acknowledged that the most recent estimates for the composite and particular person figures may be accessed from the Nationwide Well being Workforce Accounts Knowledge Portal. The beneath chart plots the estimated variety of docs per 1,000 inhabitants. With 0.7 docs per 1,000 individuals, India ranked 118 out of 181 international locations.
The beneath chart plots the estimated variety of docs, nurses and midwives per 1,000 inhabitants (the composite determine) utilizing the most recent information for international locations the place they’re out there. With a composite determine of three.06 per 1,000 individuals — behind the 4.45 mark cited by the WHO — India ranked 122 of the 181 international locations.
Dr. Kumbhar argued that India has all the time had a ample variety of docs; only a few public well being consultants had ever claimed there was a paucity. It’s only just lately, after the 1:1,000 ratio got here into the image, that questions are being raised.
The true disaster is just not the common quantity, Mr. Zadey stated. “We all know that we’ve an enormous rural-urban disparity. In rural areas, we’re nowhere near the best composite threshold.”
The info was sourced from the Nationwide Well being Workforce Accounts Knowledge Portal and Lok Sabha and Rajya Sabha replies.
devyanshi.b@thehindu.co.in
Printed – November 26, 2025 07:00 am IST