Bachelor of rural health care: do we need another cadre of health practitioners for rural areas?

INTRODUCTION The National Health Policy (NHP), 2002 envisages that keeping in mind the availability and spread of allopathic graduates in their jurisdiction, state governments would consider the need for expanding the pool of medical practitioners to include a cadre of licentiates of medical practice, as also practitioners of Indian systems of medicine and homoeopathy. Simple services can be provided by such practitioners even outside their disciplines, as part of the basic primary health services in underserved areas. The NHP also envisages that the scope of the use of paramedical manpower of allopathic disciplines, in a prescribed functional area adjunct to their current functions, would be examined for meeting simple public health requirements. This would be on the lines of the services rendered by nurse practitioners in several developed countries. These extended areas of functioning of different categories of medical manpower can be permitted after adequate training and subject to the monitoring of their performance by professional councils. Health manpower has been described by various authors as ‘the heart of the health system in any country’, ‘the most important aspect of health care systems’ and ‘a critical component in health policies’. There is a consensus that despite their importance, human resources have been a neglected component of health system development in many countries, and India is no exception.