India’s rural healthcare centres have added 3,200 doctors and 400 specialists over the past seven years, a period during which the country added more than 42,000 undergraduate medical seats, according to data in the 2023 Economic Survey released on Tuesday.

The Economic Survey data, citing annual rural health statistics, shows that the number of specialists in India’s 5,500 community health centres (CHCs) increased from 4,100 in 2014 to 4,500 in 2022. The counts of doctors at the 29,000 primary health centres (PHCs) rose from 27,400 to 30,600.

The marginal increases in the counts of doctors at PHCs and specialists at CHCs, health experts say, indicate that the efforts to add medical seats have not translated into commensurate gains for the health centres, the first points of care in rural India.

The country has added 260 medical colleges since 2014, and the numbers of undergraduate medical seats have increased steadily from around 54,000 in 2014-15 to 92,000 by 2020-21, and 96,000 in 2022-23. Postgraduate seats have increased from 23,000 to more than 64,000 in 2022-23.

Since 2014, the PHCs and CHCs have collectively added about 16,000 nurses (from 64,000 to 80,000) and 6,100 lab technicians (from 16,700 to 22,800), according to the Economic Survey data.

The CHCs serve as the first referral centres in the public health system, and are supposed to have a surgeon, an obstetrician-gynaecologist, a paediatrician, a physician and an anaesthetist.

But statistics released by the health ministry earlier this month flagged an over 80 per cent shortfall in surgeons and paediatricians, and an over 70 per cent shortfall in physicians and obstetrician-gynaecologists.

“The shortfalls in the CHCs, despite the additional medical seats, shouldn’t be any surprise,” said Oommen John, a research fellow at the George Institute for Global Health, New Delhi, a research institution.

“We’ve also seen, over the same period, a big rise in the private healthcare sector, which is likely the first choice for graduate and postgraduate doctors.”

The creation of new medical colleges and additional postgraduate seats, John said, would also generate a demand for postgraduate specialists to join as faculty.

Health experts have often cautioned that rural health centres are likely to continue facing shortages of doctors given their poor infrastructure, among other challenges in rural areas.