Inequitable distribution of health workers and inefficient skill mix are a major worry for India, top officials of the World Health Organisation (WHO) said.

"India produces around 20,000 doctors every year but there is an imbalance in the distribution of doctors across the country. Besides, the country does not produce enough allied work force (skill mix) to assist the doctors," said Poonam Khetrapal Singh, deputy regional director, WHO, on World Health Day (7 th April 2006).

Singh said that in many cases, doctors do not like to get posted in rural areas, as a result around 80 percent of the posts remain vacant in these areas.

"India needs to improve its health education and awareness campaign to address the above problem. The literacy rate has to improve further," she said adding that states like Kerala, Tamil Nadu, Maharashtra, Gujarat and Punjab were doing well in the health sector.

Besides, problems like poor working environment, inefficient skill mix and migration add to the problem.

Samlee Plianbangchang, regional director, WHO Southeast Asia region, said that migration of health workers from countries like India, Nepal, Sri Lanka and Bangladesh to developed countries was a major concern.

"Around 20 percent of the students going abroad for studies are not returning to these countries," he added. The largest numbers of doctors who migrate from Southeast Asia are from India," Samlee told reporters after unveiling a health report titled "Working together for Health".

The report revealed that India is way behind developed nations in its health force. While there are only 62.5 doctors serving 10,000 populations, the number is 166 in Britain and 548.9 in the US.

Samlee also said if India had to achieve the millennium development goal of reducing the maternal mortality rate by three-fourths and the child mortality rate by two- thirds then all these above problems had to be addressed quickly.

"There is a need for political will and increased investment in the health sector in India. The government should also formulate legislation to divide the growing distribution imbalance of doctors and bridge the urban-rural rural divide in areas like infrastructure, modern medical facilities as well as social security, personal development for health service providers."

The availability of health workers for primary healthcare varies from a low three per 10,000 population in India and Myanmar to 25 per 10,000 population in the Maldives.

In the region, Thailand and Sri Lanka are doing considerably better than countries like India.

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