The Planning Commission has proposed to train registered medical practitioners, commonly referred to as quacks, to ensure universal health coverage reaches even the remote populations.

"Affordability, accessibility and quality are three pillars of UHC. The challenge is to fill the gaps especially in rural areas where there is a problem of trained manpower. We would like to train traditional midwives and RMPs – some people call them jholawala doctors or quacks – to be used because they have been providing services in remote areas all these years. It is important to respect and use what we have. The XIIth plan document talks about this need," Syeda Hameed, a member of the commission, told The Indian Express.

India, according to the commission, had 26,329 doctors in the public sector in March 2011 against a requirement of 1,09,484, a massive shortage of nearly 76 per cent despite the fact that every year some 43,740 students are awarded MBBS.

A Health Ministry plan to train rural healthcare workers as "half–way doctors" through a course prescribed and managed by the Medical Council of India had raised hackles of the doctor lobby which claimed it would amount to leaving the rural population in the hands of semi–doctors.

Now, the ministry has renewed efforts to push it through with a different name.

Sources said the idea of using quacks as first–line health workers wasn’t received with much enthusiasm in the Plan Panel’s meetings.

It was, in fact, seen as a move that would derail states’ efforts to crack down on quackery.

Hameed admitted that the idea was greeted with a certain amount of "professional arrogance" by the Health Ministry and anticipates stiff resistance from doctors as well. She, however, added: "Supplementing the public sector is important and since they themselves will not go and work in boondocks, we need to weigh all options." Hameeda said there is a proposal to make states institute a special cadre of officers to deal solely with public health, and added that there is a need to use cheap technological innovations to make healthcare more accessible and affordable.

States, she added, would be required to invest in a management information system so that health data is easily accessed. "Though we tried to give states greater flexibility in the XIIth plan... there is a need to evolve a formula where laggard states like Bihar and Uttar Pradesh get extra funds. Right now the system is such that states like Tamil Nadu and Kerala, which have good healthcare systems in place, get most of the money," she said.