Health Services and Medical Education: A Programme for Immediate Action
The government of India’s Ministry of Health and Family Planning appointed the Group on Medical Education and Support Manpower on November 1, 1974, under the chairmanship of Dr. J. B. Shrivastav (director general of the government’s Health Services at the time). The Group’s findings were published in this report in 1975.
The Group was to devise a curriculum for
training Health Assistants who would serve as a link between qualified
medical practitioners and multipurpose health workers. The Health Assistants
would have to be familiar with the government’s basic medical aid,
preventive and nutritional, family welfare, and maternal and child welfare services.
Additionally, the Group had to suggest ways to emphasise health issues of national
importance in existing medical education programmes.
This 63-page report contains eight chapters and
three appendices, which cover such themes as health services and personnel in India,
community health and primary health centres (PHCs), problems in the country’s
existing medical education programmes, the objectives of medical education, the
Group’s recommendations, and others.
In 1975, states the Group, there was a male health worker for every 6,000 to 7,000 people in India, and a female health worker for every 10,000 people. The government of India’s Fifth Five-Year Plan (1974-79) aimed at appointing a male as well as a female worker for every 8,000 people. The Group recommended that there should be a female and a male worker for every 5,000 people by the end of the Sixth Five-Year Plan.
The Group advised that all supervisory health personnel be designated as Health Assistants, and that these assistants aid the work of doctors at PHCs, forming a link between PHCs and health workers.
Tehsil, district, regional and medical college hospitals had minimal links with the PHCs close to them. Hospitals should develop direct links with nearby PHCs and the communities that reside close to them, states the report.
The Group suggested the creation of a cadre of ‘para-professional’ or ‘semi-professional’ health workers in each community to provide basic promotive, preventive and curative health services. These could include dais, family planning workers and persons offering preventive or curative health services.
The State should establish a comprehensive and nation-wide network of health services, says the report. The programme should aim at reducing poverty, promoting nutrition, integrating the health and education sectors and organising semi-professional and professional services to provide preventive and curative healthcare.
Pre-medical education in schools should include the study of natural sciences, social sciences and humanities. Biology should be taught as a multilateral science, from the level of molecules to that of human beings, communities and populations.
The Group suggested that the government establish a Medical Health and Education Commission for the coordination and maintenance of standards in health and medical education, broadly modelled after the Ministry of Human Resource Development’s University Grants Commission.
Focus and Factoids by Archana Shukla.
Group on Medical Education and Support Manpower (Chair: Dr. J. B. Shrivastav)
Ministry of Health and Family Planning, Government of India, New Delhi