Doctors For The World: Indian Physician Emigration

Fitzhugh Mullan

Health Affairs. 2006;25(2):380-393. 

In This Article

Disparate Outcomes

Within India there are two dramatically different patient populations—the poor and the nonpoor. The health status of these two groups is strikingly different.[13] An infant born in the poorest quintile of the population is two and half times more likely to die in infancy than an infant in the top quintile and four times more likely to die in childhood. An adult from the poorest quintile is six times less likely to access hospitalization, and a pregnant woman, more than six times less likely to be attended by a medically trained person than their counterparts from the richest quintile.[14] Rural-versus-urban data show similar health disparities in percentages of births attended by skilled personnel, infant mortality, and immunization.[15]

The pronounced disparities in health between the well-to-do and the poor are dramatic even by developing-country standards and a huge challenge to rhetoric of the ruling Congress Party and Indian public health leadership. Poverty reduction and improvements in sanitation and education will certainly provide the basis for better population health. But the presence (or absence) of physicians also has a bearing on the health of populations, which reasonably raises questions about what the expatriation of large numbers of Indian physicians means for national health improvement.