India has only 1.27 anaesthesiologists for every 100,000 people, according to data from the World Federation of Societies of Anaesthesiologists. This reflects a crisis in the surgical workforce and the large gaps that exist in critical surgical and emergency care.
The World Federation of Societies of Anaesthesiologists has gathered data of anaesthesia providers – physicians, nurses and others – from countries around the world and found that a high number of countries have reported a total anaesthesia provider number of less than 5 per 100,000 population. Most of these are low income countries in sub-Saharan Africa, the West Pacific, the Caribbean, Central America and South America, South-East Asia, North Africa, the Middle East and West Asia.
A map compiled by the federation shows the large differences in access to anaesthesia in rich and poor countries. For example, the United States has more than 100,000 anaesthesia providers for a population of 323.9 million. Indonesia, on the other hand, has only 1,800 anaesthesia providers for 258.3 million people.
According to the federation’s data, India has 12,000 anaesthesia providers with qualifications in anesthesiology for a total population of 1.3 billion people. There are a total number of about 16,500 physician anaesthesia providers in the country. There are no nurse anaesthesia providers or other anaesthesia providers.
The Indian Society of Anaesthesiologists says it has 25,000 registered members, including medical students pursuing anaesthesiology at recognised colleges. However, more than half these members either do not practicing medicine or have left the country. The society estimates that there are about 13,000 practicing anaesthesiologists in India at the moment.
“It is not lucrative to be an anaesthesiologist in India,” said Dr Venkatagiri KM, secretary of the society.
Moreover, he said that anaesthesiologists do not get adequate recognition as doctors both within the medical community as well as outside. “A very small portion of the [medical] fee would be given to an anaesthesiologist even when he is as responsible as the surgeon for the patient’s operation,” he said.
The shortage of anesthetists has adversely impacted maternal and child health in India, say doctors. Anaesthesia is required in obstetrics for emergencies like Caesarean sections. According to Association of Obstetric Anaesthesiologists, about five percent of preventable anesthetic accidents that lead to maternal deaths is due to shortage of anaesthesiologists.
India has recognised this life-threatening dearth of anaesthesiologists, especially in rural areas, in the past. In 2002, the government started short-term training programmes for doctors to make up for the gap. However, researchers found that these programmes could not be sustained due to problems in implementation and lack of support from the government. Anaesthetic services and providers have largely been overlooked in the public healthcare system as is seen in the lack of posts for anaesthetists at community health centres.
The government has now introduced diploma courses to make up for the shortage of anaesthesiologists. “Though the shortage is there is both private and public sector, the government is coming up with such diplomas instead of increasing the post graduate seats in a time-bound fashion,” said Venkatagiri.