Doing the Needful: The Dilemma of India's Population Policy by G Narayana

Author:G Narayana [Narayana, G]
Language: eng
Format: epub
Tags: Social Science, Political Science, World, Asian, Regional Studies
ISBN: 9780429695377
Google: d55EEAAAQBAJ
Goodreads: 59089224
Publisher: Routledge
Published: 2021-11-28T00:00:00+00:00

The Medical Officer

At the present time each PHC serves a population of 100,000 or more, an entire development block. Plans are to convert one out of three of these to Community Health Centres which will offer specialized services. Some of the wealthier states have already put these plans into operation while others lag far behind. It is estimated that it will take about ten years to install the plan in all parts of the country. Questions have been raised about the likely success of the CHCs which will have to face competition from better equipped, more fully staffed nearby hospitals. Specialized curative services require more by way of support staff and facilities than is so far envisioned for the CHCs.

The PHC usually has three medical officers, the most senior of which is the officer-in-charge. A revamped sub-block level PHC will have one medical officer, a community health officer, an extension educator plus male and female health assistants, a lab technician and a statistician. For many years the most discussed problem concerning the operation of the PHC was the difficulty of recruiting physicians willing to serve in rural areas. With the great expansion in the number of medical schools and the output of new doctors, the lucrative urban markets for medical services have become crowded and highly competitive. There are 106 medical schools in the country. In 1983-84 the institutions turned out about 12,000 physicians plus another 2,600 who obtained post-graduate degrees.

The number of medical professionals registered with Employment Exchanges has increased markedly. In 1984 there were almost 20,000 medical professionals on the live registers of the employment exchanges. In many states the number of government positions for physicians is less than the number of applicants. There is now a fair degree of competition for openings for physicians in the government's rural health service to the point that court challenges over hiring decisions are not uncommon.

Getting a son or daughter into medical school is a major preoccupation of many parents. Physicians generally enjoy high status and have excellent earning prospects. Young male doctors, moreover, command a handsome price as prospective bridegrooms. For most graduates the goal is a career in curative medicine and in specialties in demand in urban areas. The health service, on the other hand, seeks physicians oriented toward preventive medicine who are interested in serving in rural areas. While some very fine physicians are attracted to the kind of opportunity offered by government service, it is doubtful whether a sufficient number of physicians would be available for such jobs were it not for the abundance of physicians looking for work.

Physicians posted for rural service to PHC or other out-of-the-way facilities usually have their eye on the main chance as urban practitioners. For many there is a large and painful gap between what they do as medical officers in the rural health service and what they would prefer to do if they had the opportunity.

There have been efforts to reduce this gap by placing greater emphasis on preventive medicine

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