Thursday 11 October 2012

Shortage of human resources for health in Nepal: Just a drama created by healthcare planners, managers and policy makers

Every year large numbers of different categories of human resources for health are producing in Nepal but Ministry of Health and Population always claim that there is a critical scare in human resources for health in Nepal, which I consider it just a drama created by ill-minded healthcare planners, managers and policy makers to bull, fool and rule over innocent mass who are dying for seeking basic health services and keeping them in an illusion and delusion to cheat donors to ask money to seek support from them so that they can corrupt the money that is donated in the name of poor and rural people who are deprived of man-made poverty. In the Annual Report produce by the Department of Health Services including other reports produce by external development partners always it states that there a critical shortage of human resources for health in Nepal, which is just a narrow thoughts of those professionals who can't see and analyse the production of human resources for health in Nepal. Annually only new production of human resources for health when calculating (below) I found astonishing number of human resources for health are available in Nepal and most of them are not getting jobs and either working as a volunteer or staying at home doing nothing.

If government fail to recruit and mobilise their own production of trained human resources for health in the country does it rational to say that there is a critical shortage of human resources for health? NO NEVER NOT!! They can't just cheat innocent people giving excuse of bull and blocked minded answers! Instead they have to work out thoughtfully how they can absorb the production of trained human resources for health that we have in Nepal. 

Annual Production of Human Resource for Health in Nepal:
1. MBBS (doctors): 1,900 from 16 medical colleges of Nepal (Apart from this from Bangladesh and China many Nepalese medical students are graduating every year)+

2. Bachelor in Dental Surgery (Dentist): 200 from 8 different dental college of Nepal+

3. Proficiency Certificate Level (PCL) in General Medicine (Health Assistant): 1480 (37 colleges x 40 intake per college/year)*

4. Nursing workforce: 5885^
- 103 PCL Nursing School (Annual estimated production: 3,605 i.e. average intake per year 35x105 colleges)
- 20 BSc Nursing (Estimated production in a year: 400 i.e. average 20x20 colleges)
- 47 ANM schools (Estimated production in a year: 1,880 i.e. average 40x47 colleges)

5. PCL Health Lab Tech: 1290  (43 colleges x 30 intake per college per annum)*

6. PLC Radiography: 240 (8 colleges x 30 intake per college/year)*

7. PLC Dental Science: 160 (4 colleges x 40 intake per college/year)*

8. PLC Opthalmic Science: 40 (1 college x 40 intake per year)*

9. Community Medicine Assistant (CMA): 2,440 (61 colleges x 40 intake per college per annum)*

10. Lab Assistant: 920 (23 colleges x 40 intake per college/year)*

11. TSLC Dental Hygienist: 40 (1 college x 40 intake per/year)*


As of  8 August 2012 we have 37,162 nurses (ANM: 18,463 and PLC/BSc Nurses: 18,699) registered in Nepal Nursing Council but only around 3,500 nurses are working for the Ministry of Health and Population [4]. So, is it logical to say that we've shortage of nurses in Nepal. Absolutely NOT because many of these nurses are jobless and some are working as volunteers in private hospitals.

In what extent we as a health professional agree with this statement "One of the biggest problems is an ongoing shortage of health care workers. This includes doctors, nurses and midwives. Bangladesh, Bhutan, India, Indonesia, Nepal and Myanmar have a critical shortage of trained health workers,” said the WHO in a recent September 2012 release.”These countries have fewer than 23 health workers (doctors, nurses and midwives) per 10,000 population which is considered the minimum health workforce needed to achieve 80% coverage of essential health interventions. More people lack access to health-care providers in the WHO South-East Asia Region than in WHO’s African Region,” added the WHO.
With a lack of doctors, nurses and midwives in Nepal the nation has been struggling to lift maternal mortality and child heath care services as well, but internal as well as external assistance is coming now for Nepal [5].”

However, definitely we can say that there is a shortage of midwives in Nepal because to date we don't have a separate cadre human resource for health known as a MIDWIFE in Nepal. ANMs and nurses including doctors are the one who provide maternity care to Nepalese women. This is the reason why Nepalese women are not accessing quality dignified maternity care  because these professionals (ANMs, nurses and doctors) are not trained in providing holistic women-centred maternity care respecting their rights and choices. Therefore, women complain that nurses are rude and abuse during childbirth in a health facility.

Reference

1. + Medical Colleges in Nepal http://www.comsnepal.org.np/index.php?option=com_content&view=article&id=16&Itemid=18
2. *Source: NHPC website 1 Dec 2011
3.  ^Source: FHD 2011. Report of the Workshop to Review the Implementation Status of the National SBA Programme 28-29, April 2011
4. Nepal Nursing Council's webpage access from http://www.nnc.org.np/
5.  http://womennewsnetwork.net/2012/09/17/peace-corps-nepalese-charitie/

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