Improving health service

 Nagaland Medical Council (NMC) has revealed that there are 1058 registered medical practitioners in the state, out of which 423 practitioners are specialists and rest 630 were MBBS. The statistics also show that there is one doctor for every 1800 people in the state which is much below one doctor for 1000 people at the national level. Another point is that Nagaland still does not have a medical college, while all other north east states have either one or more. Taking into consideration the international norms of health are professional availability as per population, WHO norms state the requirement of 1 doctor per 1000 population and 2 nurses per 1000 population. NER has a supply gap of 36,009 registered doctors of which taking an attrition percentage of 20 per cent, a total number of 28,007 doctors can be considered available. To meet the WHO requirement of 1 doctor per 1000 population, North-east requires additional 22, 958 doctors. Despite much funds being spent on medical and health services in Nagaland, most government hospitals are still finding shortage of doctors. This is especially pronounced in the rural areas where hospitals including PHCs are poorly manned. Most of the doctors, like in other states of India, prefer to be located in urban towns where the income prospects are alluring. This was also brought to focus during an interaction with Nagaland Medical College president Dr.Joyce Z.Angami who revealed that many government doctors continue to practice in private nursing homes after attending morning duties and even after availing Non-Practicing Allowance(NPA). This issue of government doctors practising in private clinics and hospitals despite getting NPA has been a subject of intense debates. Despite having attained statehood in 1963 and enjoying benefits of central quota in government medical colleges, the quality of health services in the state still leaves much to be desired. On the health sector, as per statistics of the National Health Profile 2016, published by Central Bureau of Health Intelligence, Nagaland had the seventh-highest per capita health expenditure (Rs 1,707) and fifth-highest health expenditure as a percentage of gross state domestic product (2.23%) among all states in 2013-14. Nagaland is also a recipient of generous central funds, yet when it comes to providing health care service, the state fares poorly in comparison with other north eastern states. Nagaland seems to have scored quite well on the number of SC, PHC and CHC established. However, availability of healthcare equipments, medicines and proper infrastructures of the district hospitals tell an altogether different story. Qualitative public health care deliveries are grossly missing in the PHCs and CHCs with acute lack of doctors, specialist and other required technicians. In institutional delivery(2016) Mizoram tops the list, followed by Sikkim, Tripura, Manipur, Arunachal Pradesh, Meghalaya, Assam then Nagaland. What ails the health sector in Nagaland appears to be lack of governance in the delivery system. There are still several communicable diseases that continue to ravage various areas, especially the rural areas owing to absence of good quality health care. Be it cancer or Malaria, TB, viral infection, Urinary Tract Infection, Respiratory Tract Infection, Gastroenteritis, Typhoid, Hepatitis, Helminthiasis these  indicate that the focus needs to be more on preventive and strengthening of quality primary healthcare services. Perhaps the NMC along with the medical fraternity can put their heads together on how to make the best out of available resources instead.