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Rural medical assistants: Not Quite The Good Doc, But The Better Bets

The heated debate over the creation of a rural healthcare cadre is far from over. Opposed by medical practitioners, the health ministry’s plans to start a four-year Bachelors in Rural Health Care course (BRHC) from this year have received a setback. The Medical Council of India (MCI) is now expected to take a fresh view. “We have to take healthcare to rural areas,” MCI board chairman Dr K.K. Talwar told Outlook. “It is an important issue. As I wasn’t involved in the earlier discussions, I need to understand the various issues. Some states have their own rural healthcare programmes and I am trying to get information about what experiences they have had.”

Currently busy clearing approvals for medical colleges before the June 15 deadline, the MCI board plans to review the proposed BRHC plans at a later date. This, when the health ministry had in January got almost all the states to support the move and chart out the BRHC syllabus. “It took a year to convince all political parties and chief ministers to support the proposal as we wanted the syllabus to be recognised,” says health minister Ghulam Nabi Azad. “Unfortunately, the MCI got influenced by medical practitioners and did not give national-level recognition.” Given this wide opposition by medical practitioners to the creation of a rural healthcare cadre, the health minister underlines that while the states are free to start such courses as is being done in some cases, “unless the course gets national-level recognition, it won’t attract good talent”. MCI’s approval is a must for the implementation of a uniform curriculum across the country.

The health minister’s concerns are not unfounded, given the continuing resistance of the Indian Medical Association to accept any alternative cadre of rural health practitioners, which had been in vogue before Independence. The decision to adopt the western model of MBBS to provide better medical care across the country has been to the detriment of large parts of rural India—most doctors shy away from working in areas which offer no career prospects even though some states offer incentives.

That’s why healthcare experts are keen on finding a viable alternative. The idea of a separate cadre of healthcare providers exists in several developed and developing countries. India too, it is felt, needs to seriously explore the concept, considering that, as against the desired ratio of one doctor per thousand population, large parts of rural India currently have just four doctors for 10,000 people.

A decade back, when newly-created Chhattisgarh tried to address the issue by starting a condensed medical course, there was opposition. Yet, despite many legal and political twists and turns, the state went ahead to train and deploy over 700 Rural Medical Assistants (RMAs) in primary health centres and sub-centres. A visit to some of these centres, many miles away from a properly equipped hospital, is an eye-opener.

Driving through lovely, thick forests early in the morning to visit some of the primary health centres in the Manpur, Mohla, Ambagarh Choki blocks of Rajnandgaon district, there’s no mistaking that we’re deep in Maoist-affected territory. From time to time, we see CRPF men scanning the road we are travelling on with landmine detectors and sniffer dogs. With villages 10 or more kilometres apart, only the ploughed fields in some areas give indication of habitation.

Read the rest of the articles here: Rural medical assistants: Not Quite The Good Doc, But The Better Bets


  1. ganpathy
    June 27, 2011 at 12:01 pm

    government should start immediately rural medical course for the welfare of poor

  2. avinash
    October 11, 2011 at 12:30 am

    this is good for poor people but RMAs beheviors like as a medical officer. they are going to their work only 3-2 days in a week. now what is the benefite of their posting ?

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