Rethinking doctor count: The story of a WHO 'norm' that it never prescribed

The World Well being Group has clarified that it has by no means issued a advice for one physician per 1,000 inhabitants, a determine extensively cited in coverage discussions. Dr Giorgio Cometto, head of WHO’s well being workforce unit, stated that the 1:1,000 ratio is a “factoid” not supported by any WHO doc, cautioning that it shouldn’t be used as a benchmark for nationwide well being workforce planning.

Regardless of this, governments have used the determine to calculate physician shortages and push for growing medical school seats, usually with out addressing the unequal distribution of medical doctors throughout states or between city and rural areas. Cometto emphasised that every nation ought to plan its well being workforce based mostly on its distinctive epidemiology, demography, funds, and well being system setup to fulfill Sustainable Improvement Targets (SDGs) by 2030, reported TOI.

The origin of the parable

Whereas WHO units a threshold of 4.45 medical doctors, nurses, and midwives per 1,000 inhabitants as a basic guideline for important SDG service protection, this doesn’t account for the differing wants of particular person nations. Medical historian Dr Kiran Kumbhar traced the 1:1,000 determine to India’s Medical Council “Imaginative and prescient 2015” report in March 2011, which didn’t cite WHO.

Later, a 14-member Excessive Stage Knowledgeable Group on Common Well being Protection in India referred to the ratio as a “WHO norm” in its October 2011 report, based mostly on earlier WHO information that drew from a 2004 international well being report. That report famous nations with fewer than 2.5 healthcare professionals per 1,000 inhabitants usually failed to realize 80% protection for expert start deliveries or measles immunisation.

Cometto and different public well being consultants warn that blindly utilizing a common ratio ignores important elements like workforce distribution, healthcare infrastructure, and inhabitants wants, and will result in poorly deliberate expansions of medical faculties.