India has 1.7 nurses/midwives and 0.928 doctors per 1,000 population. The WHO norm is three nurses per 1,000 population and one doctor per 1,100 population. As the pandemic has urged us to look closely at our healthcare systems, this observation remains important. India has seen a migration of trained healthcare professionals abroad in many developed countries. According to the Organisation for Economic Co-operation and Development (OECD) of 2017, 69,000 healthcare workers have migrated to the US, UK, Canada and Australia. 56,000 Indian nurses were already working in the same four countries.
This brain drain from India has been further triggered by migration-friendly policies from the developed countries to tackle the pandemic. OECD had exempted travel bans on healthcare workers with job offers. France offered exclusive citizenship to immigrant healthcare professionals. One year visa extension was provided by the UK. Some countries generally process the visa applications of healthcare workers. These policies have tactfully helped these nations to tackle the pandemic a bit more smoothly. Higher wages, better working conditions and the environment have propelled further the brain drain from India. Comparatively, wages are lower in India. The work conditions aren’t profound. The public sector has a higher level of competition but pays more than the private sector.
Hence, the need for a better healthcare system has been explicitly highlighted by the pandemic. India has only five beds per 10,000 people as of 2020. That remains one of the lowest in the world. In 2014, the government stopped issuing No Objection to Return to India (NORI) certificates to doctors. It is a US government requirement for doctors who migrate to the US on a J1 visa and wish to extend their stay beyond three years. It ensures that the doctors have to return to India at the end of 3 years. The government also started including nurses in the Emigration Check Required (ECR) category to bring transparency in nursing recruitment and reduce exploitation in those countries. However, spending on healthcare infrastructure, increasing minimum pay and providing decent working conditions are some measures that have to be applied to stop the migration of healthcare workers. Initiatives have to be employed to seek healthcare professionals from other developing nations to our country to reduce the strain on our professionals.
The third wave of the pandemic is still to hit us, and hence we must prepare ourselves as early as possible to contend with it. The government should work on policies that would reverse the migration, on bilateral agreements that would create a brain-share among countries. Infrastructure should be improved so that the students must not resort to going abroad for studying. It will help them generate more scope in the country.
This article has been written by Ritu Katkar for The Paradigm.
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