NDLI: Shortage and inequalities in the distribution of specialists across community health centres in Uttar Pradesh, 2002

Content Provider	Springer Nature : BioMed Central
Author	Singh, Aditya
Abstract	Background The onus of providing affordable access to specialist services in rural India primarily lies with publicly funded rural hospitals, also known as community health centres (CHCs). However, no studies have attempted to measure the change in the shortage and distributional inequalities of specialists in the publicly funded rural hospitals of Uttar Pradesh (India). This study attempts to fill that gap. Methods The study uses data from the three latest rounds of the District-Level Household Survey, covering a period of 10 years spanning from 2002 to 2012. Shortages were measured against the Indian Public Health Standards for CHCs, and inequalities were measured using Gini and Theil indices, with the latter decomposed to reveal the source of the inequalities. Negative binomial regression was applied to examine the association between facility characteristics and the availability of specialists in CHCs. Results The current shortage of specialists stands at 80.7% of the total requirement. Currently, 62.1% of CHCs are functioning without a specialist. The distribution of specialists across CHCs has become progressively uneven over the study period, as shown by the rise in the Gini index (from 0.41 in 2002–2004 to 0.74 in 2012–2013). Decomposition analysis reveals that the contribution of within-district inequalities to overall inequality remains high (85.4% of total inequality). About 50% of within-district inequality is contributed by only 20 districts, most of which belong to eastern and central Uttar Pradesh. The analysis of factors affecting the distribution of the current specialist workforce revealed that the number of available specialists at a CHC is positively associated with the availability of residences for doctors and regular electricity supply, and negatively associated with CHC location and the distance of the CHC from the district headquarters. Conclusion The findings suggest that Uttar Pradesh not only needs to recruit more specialists, but it also requires proper implementation of deployment and retention policies to ensure equitable access to specialist care for rural populations. Ensuring the availability of quality accommodations and basic amenities at all CHCs, as well as adequate transport and rural allowance, could help increase the chances of specialists staying in rural and far-off CHCs.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-019-4134-x.pdf
Ending Page	16
Page Count	16
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-019-4134-x
Journal	BMC Health Services Research
Issue Number	1
Volume Number	19
Language	English
Publisher	BioMed Central
Publisher Date	2019-05-24
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Human resources for health Specialists Community health centres India Uttar Pradesh Health worker shortage
Content Type	Text
Resource Type	Article
Subject	Health Policy

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Stakeholder perspectives on proposed policies to improve distribution and retention of doctors in rural areas of Uttar Pradesh, India

Provider imposed restrictions to clients’ access to family planning in urban Uttar Pradesh, India: a mixed methods study

Anganwadi worker time use in Madhya Pradesh, India: a cross-sectional study

Healthcare seeking behaviour among self-help group households in Rural Bihar and Uttar Pradesh, India

A comparison of intensive vs. light-touch quality improvement interventions for maternal health in Uttar Pradesh, India

Workforce problems at rural public health-centres in India: a WISN retrospective analysis and national-level modelling study

Leveraging the private sector for child health: a qualitative examination of caregiver and provider perspectives on private sector care for childhood pneumonia in Uttar Pradesh, India

How are gender inequalities facing India’s one million ASHAs being addressed? Policy origins and adaptations for the world’s largest all-female community health worker programme

Knowledge, provision of information and barriers to high quality medication abortion provision by pharmacists in Uttar Pradesh, India

Shortage and inequalities in the distribution of specialists across community health centres in Uttar Pradesh, 2002–2012

Similar Documents

Stakeholder perspectives on proposed policies to improve distribution and retention of doctors in rural areas of Uttar Pradesh, India

Provider imposed restrictions to clients’ access to family planning in urban Uttar Pradesh, India: a mixed methods study

Anganwadi worker time use in Madhya Pradesh, India: a cross-sectional study

Healthcare seeking behaviour among self-help group households in Rural Bihar and Uttar Pradesh, India

A comparison of intensive vs. light-touch quality improvement interventions for maternal health in Uttar Pradesh, India

Workforce problems at rural public health-centres in India: a WISN retrospective analysis and national-level modelling study

Leveraging the private sector for child health: a qualitative examination of caregiver and provider perspectives on private sector care for childhood pneumonia in Uttar Pradesh, India

How are gender inequalities facing India’s one million ASHAs being addressed? Policy origins and adaptations for the world’s largest all-female community health worker programme

Knowledge, provision of information and barriers to high quality medication abortion provision by pharmacists in Uttar Pradesh, India

Shortage and inequalities in the distribution of specialists across community health centres in Uttar Pradesh, 2002–2012