Hazarika Indrajit
Australian Health Workforce Institute, University of Melbourne, Melbourne, Australia, Public Health Foundation of India, Vasant Kunj Institutional Area, New Delhi, India.
WHO South East Asia J Public Health. 2013 Apr-Jun;2(2):106-112. doi: 10.4103/2224-3151.122944.
India faces an acute shortage of health personnel. Together with inequalities in distribution of health workers, this shortfall impedes progress towards achievement of the Millennium Development Goals. The aim of this study was to assess health-workforce distribution, identify inequalities in health-worker provision and estimate the impact of this maldistribution on key health outcomes in India.
Health-workforce availability and production were assessed by use of year-end data for 2009 obtained from the Indian Ministry of Statistics and Programme Implementation. Inequalities in the distribution of doctors, dentists, nurses and midwives were estimated by use of the Gini coefficient and the relation between health-worker density and selected health outcomes was assessed by linear regression.
Inequalities in the availability of health workers exist in India. Certain states are experiencing an acute shortage of health personnel. Inequalities in the distribution of health workers are highest for doctors and dentists and have a significant effect on health outcomes.
Although the production of health workers has expanded greatly in recent years, the problems of imbalances in their distribution persist. As India seeks to achieve universal health coverage by 2020, the realization of this goal remains challenged by the current lack of availability and inequitable distribution of appropriately trained, motivated and supported health workers.
印度面临卫生人员严重短缺的问题。加上卫生工作者分布不均，这一短缺阻碍了实现千年发展目标的进程。本研究的目的是评估卫生人力分布情况，确定卫生工作者提供方面的不平等现象，并估计这种分布不均对印度关键卫生成果的影响。
利用从印度统计与计划执行部获得的2009年年终数据评估卫生人力的可获得性和产出情况。利用基尼系数估计医生、牙医、护士和助产士分布的不平等情况，并通过线性回归评估卫生工作者密度与选定卫生成果之间的关系。
印度存在卫生工作者可获得性方面的不平等现象。某些邦正面临卫生人员严重短缺的问题。卫生工作者分布的不平等在医生和牙医中最为严重，并对卫生成果有重大影响。
尽管近年来卫生工作者的产出大幅增加，但他们分布不均衡的问题依然存在。随着印度力求在2020年前实现全民健康覆盖，目前缺乏经过适当培训、积极性高且得到支持的卫生工作者以及分布不均的情况仍然对实现这一目标构成挑战。
