The heartland of India and most populous state, with over 230 million residents, Uttar Pradesh has long struggled to match the scale of its health infrastructure.
A major contributor to India’s GDP, UP’s health system has failed to keep pace with the needs of its people, leaving many without access to medical care.
The Doctor Shortage
In 2025, the UP government accepted a shortage of nearly 5,000 doctors between its hospitals and medical colleges.
The Allahabad High Court then ordered the submission of figures on doctor vacancies in the state’s districts, finding that over 19,000 doctor posts had been sanctioned for the Provincial Medical Health Services cadre.
Only around 14,000 doctors were in post, including regular staff, redeployed doctors, walk-in hires and National Health Mission appointees.
AYUSH doctors are folded into the national ratio to arrive at the claimed 1:811 figure; the inclusion is a way of inflating the real number of allopathic doctors available to patients, Dr T Sundararaman, former executive director of the NHSRC, said.
UP has some of the lowest doctor-to-population ratios in the country historically and would require nearly two lakh additional doctors to meet the World Health Organisation standard of one doctor per 1,000 inhabitants.
As India’s national doctor-to-population ratio has increased overall, states like Bihar and Uttar Pradesh, which have higher population densities and lower health infrastructure, struggle to meet the standard.
Rural India Bears the Brunt
A study on the health infrastructure of UP published recently found that vacancies in Sub-Centres, Primary Health Centres and Community Health Centres were 42, 51 and 44 per cent below their respective targets.
“The NSSO projections show that the ministry’s presumption of an 80 per cent active physician workforce appears somewhat inflated,” Dr Soham Bhaduri, Chief Editor of The Indian Practitioner, said.
This was higher than the national vacancy averages of 25, 31 and 36 per cent.
The authors blame inadequate investment, a lack of human resources, and inefficient allocation, and suggest a larger budget for the social sector, mainly primary healthcare.
With nearly 97 per cent of Uttar Pradesh’s area being classified as rural, and over three-quarters of its population living in rural regions, vacancies in Sub-Centres and Primary Health Centres left millions without any nearby option of healthcare.
For many families, even minor treatment will require a journey to reach a district or private hospital, and that can be an enormous strain on the poor.
Outcomes That Reflect the Gap
The state data has shown its infant mortality rate well above the national average, with a study linking physician shortages to high child mortality rates.
The findings suggest that an increase in doctors by 1 per 1,000 people could reduce the infant mortality rate by double digits within just a few years.
Uttar Pradesh’s maternal mortality rates and child stunting rates have been well below the national averages as well.
Signs of Movement
A report by Medical Dialogue stated that India’s national doctor-to-population ratio has steadily climbed to roughly 1:811.
Government figures presented to parliament earlier this year suggest the opening of nearly double the number of medical colleges since 2014, from 387 to 818 and steep increases in the number of undergraduate and postgraduate medical seats.
An increase in both the number of medical colleges and doctor recruitment schemes within UP begins to address its shortage gap on a local level.
It will take years for the construction of new medical colleges and increases in postgraduate medical education to begin to fill the gap.
Addressing Uttar Pradesh’s healthcare gap will require years of persistent effort. Improving the quality of rural healthcare infrastructure and physician recruitment incentives will be necessary to begin to meet the demand for care across the state.
Until then, thousands of families continue to suffer at the hands of inadequate and inaccessible primary healthcare.
