Chandigarh: Punjab’s rural healthcare system is grappling with a severe shortage of specialist doctors, with not a single one of the state’s 84 functioning rural Community Health Centres (CHCs) having all four essential specialists — surgeons, obstetricians and gynaecologists, physicians and paediatricians. The situation is only marginally better in urban areas, where just three of 79 CHCs have the complete team, exposing significant gaps in the state’s secondary healthcare infrastructure.The findings in the Union health ministry’s report — Health Dynamics of India: Infrastructure and Human Resources, 2024-25 — reveal that 224 of the 268 sanctioned specialist posts at rural CHCs are vacant, leaving just 44 specialists in position. This means nearly 84% of sanctioned specialist posts remain unfilled.The shortage is particularly acute in individual specialities. Against 67 sanctioned posts for surgeons at rural CHCs, only 10 are occupied, leaving 57 vacant. Similarly, of 71 sanctioned posts for obstetricians and gynaecologists, just 11 are filled, while 60 remain vacant. The position of physicians is equally concerning, with only eight in position against 56 sanctioned posts. Paediatricians account for 15 appointments against 74 sanctioned posts, leaving 59 vacant.The shortfall extends to anaesthetists, who are critical for emergency surgeries and obstetric procedures. Of 84 rural CHCs, only 29 have sanctioned posts for anaesthetists, of which just three are occupied, leaving 26 vacant.The situation in urban CHCs is also far from satisfactory. Of the 346 sanctioned specialist posts, only 121 are occupied, leaving 225 vacant. Just 26 surgeons are in position against 77 sanctioned posts, while 36 obstetricians and gynaecologists are available against 97 posts. The number of physicians stands at 27 against 79 sanctioned posts, and only 32 paediatricians are in position against 93 sanctioned posts.The report also highlights a significant shortage of doctors at hospitals above the CHC level. At standalone sub-divisional hospitals, only 235 doctors are in position against 575 sanctioned posts, while 390 specialists are available against 661 sanctioned posts. At standalone district hospitals, 328 doctors are working against 570 sanctioned posts, while 533 specialists are in position against 713 sanctioned posts.There are, however, some areas where the state appears to have improved its manpower position. At rural Primary Health Centres (PHCs), the number of doctors and medical officers has increased from 373 in 2005 to 445 in 2025. Against a requirement of 397, the state has 750 sanctioned posts, although 305 of these remain vacant. The report records a surplus of 48 doctors against the prescribed requirement. A similar position is reflected in urban PHCs, where 156 doctors are in position against a requirement of 124, although 78 of the 234 sanctioned posts remain vacant.The shortage of nursing personnel, laboratory technicians and other frontline healthcare workers, however, remains a major concern.At rural PHCs and CHCs, only 981 nursing staff are in position against a requirement of 1,634, leaving 884 posts vacant and a shortfall of 653 against the prescribed requirement. Against a requirement of 565 laboratory technicians, only 374 are in position, leaving 262 posts vacant and a shortfall of 191.The gaps are also visible in the availability of healthcare facilities in proportion to population. Against a requirement of 595 rural PHCs, Punjab has 397, resulting in a shortfall of 198 (33%). The state has 84 rural CHCs against a requirement of 148, leaving a deficit of 64 centres (43%). The position is even worse in urban areas, where 124 PHCs are functioning against a requirement of 265, translating into a shortfall of 141 centres (53%).Punjab has 2,857 rural sub-centres against a requirement of 3,575, leaving a shortfall of 718 (20%). The infrastructure available at existing health facilities also presents a mixed picture. Of the 397 rural PHCs, only 184 function round the clock, while 122 have functional labour rooms and just 11 have functional operation theatres. In urban areas, only 26 of 124 PHCs function on a 24-hour basis, 21 have functional labour rooms and three have functional operation theatres.At rural CHCs, 81 of the 84 have functional laboratories and 77 have functional labour rooms, but only 42 have functional operation theatres. Further, only 39 have at least 30 beds, 45 have newborn care corners and 49 have functional X-ray machines.In urban CHCs, 75 of 79 have functional laboratories, 55 have functional operation theatres and 71 have functional labour rooms.However, only 49 have at least 30 beds, 48 have newborn care corners and 65 have functional X-ray machines.The manpower position of Community Health Officers at rural sub-centres is relatively better, with 2,360 in position against a requirement of 2,448, although 340 sanctioned posts remain vacant.Despite repeated attempts, health minister Dr Balbir Singh was not available for comments.SPECIALIST SHORTAGE AT RURAL CHCsSpecialist posts vacant out of 268 sanctionedSpecialists in position: 44Surgeons: 10 against 67 postsObstetricians and gynaecologists: 11 against 71 postsPhysicians: 8 against 56 postsPaediatricians: 15 against 74 postsCHCs with all four specialists: ZeroURBAN CHCs NO BETTERSpecialist posts vacant out of 346 sanctionedSpecialists in position: 121Surgeons: 26 against 77 postsObstetricians and gynaecologists: 36 against 97 postsPhysicians: 27 against 79 postsPaediatricians: 32 against 93 postsCHCs with all four specialists: 3 out of 79