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Allied and Healthcare Professionals (AHPs) make a significant contribution to the healthcare delivery system. During any health crisis, they are the front warriors who help to scale up healthcare services under the supervision of Doctors and Nurses. Despite a huge demand for their services, this sector is highly fragmented in India mainly due to the absence of a central regulatory authority.
The first formal attempt to assess the role of AHP in the Indian healthcare delivery system was made by the Ministry of Health and Family Welfare by launching a study led by the Public Health Foundation of India (PHFI), it defined the role of AHP as: “Individuals who are involved with the delivery of health or healthcare related services, with qualification and competence in therapeutic, diagnostic, curative, preventive and/or rehabilitative interventions. They could work in interdisciplinary health teams in varied healthcare setting that include doctors, nurses and public health professionals to promote, protect, treat and/or manage a person’s physical, mental, social, emotional, environmental health and holistic well-being.” In other words, AHPs’ services are mainly focused on keeping people ‘healthy’ rather than ‘fixing ill-health’; the latter remains in the hands of Doctors and Nurses.
The recent policy level effort in acknowledging the importance of AHPs in the healthcare delivery system is “Allied and Healthcare Professions Bill, 2018” which recognizes 53 professions of AHPs, brings working balance between medical professionals and AHPs and sets guidelines for AHPs’ education, services, and regulation. In many ways, this Bill has been pivotal in recognizing the role of AHPs in the healthcare system. Once enacted, it has the potential to create multiplier effect for India.
Impact on Healthcare Delivery
India’s struggle to meet the healthcare needs of its growing population is mainly due to two major challenges. Firstly, it is facing a “scarcity of financial resource”. The World Health Organization ranked India 184 out of 191 in terms of gross domestic product (GDP) percentage spend on healthcare. Secondly, there is a “shortage of human resources” at all levels of the healthcare system. In fact, the country is facing an estimated shortage of 6 lakh Doctors, 2 million Nurses and over 6.5 million AHPs.
With the advancements in technology, it is now imperative to create a fresh vision for healthcare delivery based on a multi-disciplinary team-based framework. Any investment in creating a strong cadre of AHPs can play a significant role in realizing this new vision and will also prepare us for a better response in the face of any future health crisis.
Impact on Job Creation
Considering India’s huge population, growth of private health service providers, launch of schemes like Ayushman Bharat, and technological advancements, one can easily estimate the number of new job opportunities India will create. Yet, if we look at the current availability of healthcare workers in India, the number of AHPs is not even 5 percent of the current demand. As per the 2012 PHFI Report, there has been a shortfall of 64 lakh AHPs, and India can reap huge economic benefits by investing in creating quality AHPs.
Impact on Training Standardisation
Standardising AHP training programmes is a key improvement area, but existing skilling programmes have been observed to not be able to meet international standards. This is critical so that Indian youth can be better prepared for both national and international job opportunities.
It is very encouraging, therefore, to see that the new Allied and Healthcare Professions Bill, 2018 recognizes 53 professional profiles clubbed under 15 major professional categories coded according to the ILO documentation of the International Standards for Classification of Occupations (ISCO)-08 so as to allow for global recognition and mobility. The Bill also defines that AHPs should have a minimum of 2000 hours (and Healthcare Professionals minium 3600 hours) of training and creates a provision for certification of skilled workers who have undergone formal training of less than 2000 hours under Skill India initiative.
Impact on Women LFPR
Among the G-20 States, India is second from the bottom in women participation in workforce. Women Labour Force Participation Rate (LFPR) is at historc low at 23.3 percent. Nearly 120 million Indian women at least have a secondary education do not participate in the workforce for various personal, social and economic reasons. The nature of job also acts as an important barrier for women.
AHP job roles are women-friendly. Mainly due to their caring nature and the patients’ preference (e.g. female patients prefer to be helped by female AHPs than male), women are more likely to be hired in this sector. The aspirational nature of this job and the support extended by corporate hospitals and private clinics can encourage women to take up these jobs.
Our experience at Dr. Reddy’s Foundation (DRF) has been similar while running placement linked healthcare programs to create quality AHPs. In our “Core Employability Skills” Programme, ratio of men to women participants is at 56:44. However, in our “AHP Skilling Program”, this ratio is at 25:75. Moreover, 82 percent of the women who had been 10th-12th standard pass started working after completing 600 hours of residential training with a monthly salary range of INR 12000 to 16000.
In a country with a population of 1.36 billion, where the quality of healthcare delivery is lagging behind, building a strong cadre of AHPs can be a strategic intervention. The time is ripe for bringing a systemic change by introduction of Allied & Healthcare Professions Act and investing in programmes to create quality AHPs at scale, to meet national & global demands.