A report prepared by Public Health Foundation of India (PHFI) shows a gap of 20.42 lakh dental assistance-related technologists, 18.22 lakh rehabilitation-related workforce, 8.93 lakh miscellaneous health workers and 8.58 lakh surgery and anaesthesia-related professionals.

As per the report, there is a gap of around 2.36 lakh medical technologists, 1.98 lakh surgical and intervention technology-related health professionals, 1.28 lakh opthalmology-related workers, 61,670 medical laboratory professionals and over 19,217 radiography and imaging experts.

The report prepared after a nation-wide study was presented to Health Minister Ghulam Nabi Azad and adopted by the Union Health Ministry for implementation of its recommendations.

It suggests increasing paramedic workforce by setting up allied health human resource institutes offering post-graduate and other shorter courses, besides seeking stricter regulation of such education through a separate over-arching body and making stricter norms to bring them on a par with world class.

Among states having the widest gaps in health manpower, Maharashtra comes second with 5.65 lakh less paramedics and Bihar third with 5.28 lakh shortfall. While West Bengal has 4.62 lakh less health workforce, there is a shortage of 4.22 lakh health professionals in Andhra Pradesh and 3.68 lakh less allied health professionals in Tamil Nadu.

As per Census of India estimates, there are only 3,587 dieticians, 13,678 optometrists, 16,240 medical equipment operators and 99,010 medical assistants, 2,658 dental assistants, 7,265 physiotherapists, 15,396 modern health associates for every 10,000 Indians, indicating poor density.

Based on estimates, largest gap of 23,000 ophthalmology professionals was found in Uttar Pradesh followed by Maharashtra (12,600) and a moderate gap of 10,300 to 12,000 in Bihar and West Bengal. Andhra Pradesh had a gap of 9,100.

The gap of rehabilitation-related professionals was the second largest among all categories, with gaps found in Uttar Pradesh, Bihar, West Bengal, Maharashtra and Andhra Pradesh in numbers ranging from 2,40,800 to 1,08,100 workers.

Results based on adjusted indices showed the largest gap of 34,600 workers for surgical and intervention technologies in Uttar Pradesh, while moderate gaps in the range of 18,000 to 19,300 were found in Maharashtra and Bihar. West Bengal and Andhra Pradesh had gaps in the range of 14,400 to 15,700.

Medical laboratory technicians are needed mostly in Uttar Pradesh with 12,200 professionals, while such estimates ranged from 6,500 to 4,500 for Maharashtra and Bihar.

The greatest need of radiology and imaging professionals is in Uttar Pradesh (adjusted estimate 3,600). Other states with gaps are Maharashtra, Bihar, West Bengal, Andhra Pradesh, Gujarat, Assam and Delhi.

Audiology and speech-related professionals account for the smallest gap among all Allied Health Professionals (AHPs), with 1,500 of them needed in Uttar Pradesh. Other states with large gaps are Maharashtra, Bihar, West Bengal, Tamil Nadu and Andhra Pradesh.

A total of 39,300 medical technologists are needed in Uttar Pradesh, with requirement in Maharashtra, Bihar, West Bengal and Andhra Pradesh ranging between 16,500 and 22,000, taking into account access and efficiency parameters.

The report says dental technologists account for the largest gap among all types of AHPs with the maximum need being in Uttar Pradesh of about 3,37,400. The gaps in other states like Maharashtra, Bihar, West Bengal and Andhra Pradesh are significantly less than that in Uttar Pradesh, ranging from 1,42,900 to 1,90,000.

Healthcare professionals helping in surgery and anaesthesia also add significantly to the gap of AHPs in India. Again, Uttar Pradesh has the largest gap of 1,42,100. Other states of interest include Maharashtra, Bihar, West Bengal and Andhra Pradesh with gaps ranging from 60,000 to 80,000 based on adjusted estimates.

Recent figures in World Health Statistics 2011 show density of doctors in India is 6 for a population of 10,000, while that of nurses and midwives is 13 per 10,000 population. India has a doctor to population ratio of 0.5: 1000 in comparison to 0.3 in Thailand, 0.4 in Sri Lanka, 1.6 in China, 5.4 in the UK, and 5.5 in the US.

The recommendations come after studying 1,000 institutes, data collected from over 270 medical and allied health institutes and visits to 18 national institutes of excellence, besides consulting over 300 experts and desk review.

The Health Ministry has already undertaken the "National Initiative for Allied Health Sciences" (NIAHS) to augment the skilled allied healthcare professionals in the country.

It has also announced setting up of National Institute of Paramedical Sciences (NIPS), Regional Institute of Paramedical Sciences (RIPS) and supporting state government medical colleges for conducting allied health science courses.

The study has found that AHPs are defined and interpreted differently within and among countries and are largely known as 'paramedics' in India.

The report calls for standardised comprehensive definition of AHP along with a defined career pathway, salary structure and cadre formation to ensure their growth prospects.

It also feels that a considerable regulatory gap exists in allied health space due to lack of comprehensive regulatory framework and absence of centres for excellence or apex bodies for professional development and training of AHPs.

"It is recommended to set up a National Board for Allied Health Sciences as an interim measure to undertake the work of capacity augmentation and re-organisation for this group of the healthcare workforce," the report says.

The report has recommended Public-private partnership to augment health workforce capacity and recommended setting up of autonomous national and regional allied health sciences institutes for effective management funded by the Centre, with land from states.