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New Delhi, Sept. 24: The Medical Council of India (MCI), under orders from Delhi High Court, has approved a syllabus for a proposed three-year course to create rural health workers who can deliver emergency and out-patient care for simple complaints.
The health ministry is expected to take decisions this week on the syllabus and other key steps needed to roll out the course primarily intended for rural students who have passed Class XII, senior doctors and officials familiar with the proposal said.
The high court had last month given the MCI six weeks to finalise the syllabus for the course, pledged by the Union government more than two years ago but opposed by sections of doctors, including the Indian Medical Association (IMA).
“There will be no competition with doctors,” said Vinod Paul, head of paediatrics at the All India Institute of Medical Sciences, New Delhi. He was among a panel of doctors who helped pencil the syllabus.
The IMA has opposed the proposal, saying it will produce “half-baked” health care providers who will not be adequately trained to practise medicine.
But Paul took a different view. “We’re looking at the health sub-centre level where there are no doctors at all today,” he told The Telegraph. India has about 146,000 sub-centres, each catering to a cluster of five to 10 villages. People in such villages typically have to travel up to 30km to seek doctors.
The course will include basic elements of anatomy, physiology, diagnosis, pharmacology, but “only at a simplistic level”, so that the health workers are able to provide emergency care to patients and refer them to doctors if required, Paul said.
The workers are expected to be trained to assess fever, bandage wounds, control bleeding, splint simple fractures and provide first-aid to patients with convulsions. They could also supervise care recommended by doctors in primary health centres or district hospitals.
But officials caution that the syllabus is only a first step towards creating the new cadre of rural health workers. “Many tasks lie ahead,” said Keshav Desiraju, additional secretary in the health ministry. The course is expected to be offered by universities in association with district hospitals.
District hospitals with a minimum number of beds and patient load would need to be identified, appropriate teaching materials (textbooks) need to be developed, and the faculty needs to be brought in, Desiraju said.
The ministry had accepted the proposal for the course from a medical task force more than two years ago amid continued shortages of doctors in rural areas. Figures from the ministry suggest there is a 76 per cent shortfall in some areas.
“We’re hoping existing health workers, such as midwife-nurses in sub-centres, can also upgrade themselves through this course. That will help health care reach faster in areas with no doctors at all,” said Meenakshi Gautham, a public health analyst who had petitioned the high court seeking speedy introduction of the course.
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