Executive Summary:
This document is a response to Lok Sabha Unstarred Question No. 1115 regarding the MBBS doctor-to-population ratio in the Nashik district of Maharashtra, and the steps taken to improve the availability of qualified doctors in the region. It provides data on the national doctor-to-population ratio and outlines various government measures to improve doctor availability in rural and remote areas. The response also highlights the implementation of the eSanjeevani telemedicine service in Nashik.
Key Points / Main Content:
* **Doctor-Population Ratio:**
* Nationally, the estimated doctor-to-population ratio is 1:811, considering both allopathic and AYUSH practitioners, assuming 80% availability.
* Specific doctor-to-population ratio data for the Nashik district is not available.
* **Government Measures to Improve Doctor Availability:**
* **Family Adoption Programme (FAP):** Incorporated into the MBBS curriculum to provide equitable healthcare access to the rural population, involving medical colleges adopting villages and students adopting families.
* **District Residency Program:** Posting of second/third-year PG students of medical colleges in district hospitals.
* **Financial Incentives:**
* Hard area allowance for specialist doctors serving in rural and remote areas, including residential quarters.
* Honorarium for Gynaecologists (EmOC trained), Paediatricians, and Anesthetists (LSAS trained) to increase specialist availability for Cesarean Sections in rural areas.
* Special incentives for doctors and ANMs for timely antenatal care checkups.
* States allowed to offer negotiable salaries to attract specialists, including "You Quote We Pay" strategies.
* **Non-Monetary Incentives:** Preferential admission in postgraduate courses for staff serving in difficult areas and improved accommodation in rural areas.
* **Multiskilling:** Support for multiskilling of doctors under NHM to address specialist shortages.
* **Skill Upgradation:** Skill upgradation of existing HR under NRHM for improved health outcomes.
* **Telemedicine:** Implementation of the national telemedicine service, eSanjeevani.
* As of July 21, 2025, 643 health facilities registered, 614 operational, 556 providers, and 337 practitioners onboarded in Nashik district.
* eSanjeevani has facilitated 660,719 teleconsultations in the district.
Impact Analysis:
* **MBBS Doctors:**
* Impact: Involvement in the Family Adoption Programme and potential participation in rural service incentives.
* Action Required: Engage in the Family Adoption Programme and consider opportunities for rural service with associated incentives.
* **Specialist Doctors (Gynaecologists, Paediatricians, Anesthetists):**
* Impact: Opportunity to receive honorariums and hard area allowances for serving in rural and remote areas.
* Action Required: Consider service in rural/remote areas to leverage financial incentives and contribute to improved healthcare access.
* **Medical Colleges:**
* Impact: Required to adopt villages under the Family Adoption Programme and facilitate the District Residency Program.
* Action Required: Implement the Family Adoption Programme and support the posting of PG students in district hospitals.
* **State Governments:**
* Impact: Flexibility in offering negotiable salaries and implementing strategies like "You Quote We Pay."
* Action Required: Utilize flexible salary strategies to attract specialist doctors to underserved areas.
* **Auxiliary Nurse Midwives (ANMs):**
* Impact: Eligibility for incentives for ensuring timely antenatal care checkups.
* Action Required: Continue to ensure timely checkups and recording for antenatal care to be eligible for incentives.
* **Citizens of Nashik District (Especially in Rural Areas):**
* Impact: Improved access to healthcare services through increased doctor availability and telemedicine.
* Action Required: Utilize the eSanjeevani platform and other healthcare initiatives to access medical consultations and services.
Key Entities Referenced
Ministry of Health and Family Welfare: The Indian government ministry responsible for health policy.
Nashik district of Maharashtra: A district in the state of Maharashtra, India, which is the focus of the question regarding MBBS doctor availability.
National Medical Commission NMC: Statutory body responsible for maintaining the medical education system.
AYUSH: Refers to traditional and non-conventional systems of healthcare and medicine in India
Family Adoption Programme FAP: An initiative incorporated into the MBBS curriculum to provide equitable healthcare access to the rural population by medical colleges adopting villages.
District Residency Program: A program by NMC where second/third year PG students of medical colleges are posted in district hospitals.
National Health Mission NHM: An Indian government programme to address the health needs of under-served rural areas.
eSanjeevani: A national telemedicine service implemented in India.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO.1115
TO BE ANSWERED ON25THJULY, 2025
MBBS DOCTORSIN NASHIK
1115.SHRIRAJABHAU PARAGPRAKASH WAJE:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) the current MBBS doctor-to-population ratio in Nashik district of Maharashtra along with
the separate data for urbanandrural areasandthe mannerinwhich it compareswith the State
andnationalaverage;
(b) whether any concrete steps have been taken by the Government to improve the
availability of qualified MBBS doctors in Nashik district including rural, hilly and tribal
pocketsandtobridge the urban-rural gapinmedicalservices;
(c) if so, the details of such measures including establishment of new medical colleges,
recruitment drives, rural service incentives, telemedicine initiatives and any special schemes
for retainingdoctorsinremote areasof Nashik;
(d) if not,the reasons for the shortfall, if any; and
(e) whether any proposals are under consideration to address this critical gap in Nashik’s
public healthcare system andif so, the detailsthereof?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY
WELFARE
(SMT. ANUPRIYAPATEL)
(a) to (e): As per information provided by National Medical Commission (NMC), there are
13,86,157 registered allopathic doctors. The Ministry of AYUSH has informed that there are
7,51,768 registered practitioners in the AYUSH system of medicine. Assuming that 80% of
registered practitioners in both the allopathic and AYUSH systems are available, the doctor-
population ratio in the country is estimated to be 1:811. Specific data in respect of Nashik
District isnot available.
The Government has taken various measures to improve the availability of doctors in rural
andremote areasinthe countrywhich include:- The Family Adoption Programme (FAP) has been incorporated into the MBBS
curriculum to provide equitable healthcare access to rural population. FAP involves
medical colleges adopting villages, and MBBS students adopting families within these
villages.
Under District Residency Programof NMC second/third yearPGstudents of medical
collegesare posted indistrict hospitals.
Hard area allowance is provided tospecialist doctors for serving inrural andremote
areasandfor theirresidential quarters.
Honorarium to Gynaecologists/Emergency Obstetric Care (EmoC) trained,
Paediatricians & Anesthetist/ Life Saving Anaesthesia Skills (LSAS) trained doctors is
provided to increase availability of specialists for conducting Cesarean Sections in rural
& remote area.
Special incentives for doctors andincentive for Auxiliary Nurse Midwife(ANM) for
ensuring timely checkup and recording for antenatal care and adolescent reproductive
andsexualhealth.
States are allowed to offer negotiable salary to attract specialist including flexibility
instrategiessuch as “You Quote We Pay”.
Non-Monetary incentives such as preferential admission in postgraduate courses for
staff serving in difficult areas and improving accommodation arrangement in rural areas
have also beenintroducedunder NHM.
Multi-skilling of doctors is supported under NHM to overcome the shortage of
specialists. Skill upgradation of existing HR is another major strategy under NRHM for
achievingimprovement inhealthoutcomes.
Implementation of a telemedicine service known as national telemedicine service
(eSanjeevani). As of 21st July 2025, total 643 health facilities are registered, 614 health
facilites are operational, 556 providers and a total of 337 practitioners have been on
boarded in the Nashik district on the eSanjeevani platform. The platform has facilitated
a cumulativetotal of 6,60,719 teleconsultationsinthe district.
****