Nursing Infrastructure in India

Recently, the Central Government has directed States to overcome the regional disparity in availability of nursing colleges which is found to be skewed in five southern states and three western states in the country.

• This has become difficulty for students of Eastern and Central India due to lack of seats.

The Skewed Nursing Infrastructure:

• About 64% of the nursing workforce is currently trained in just eight States.

• Around 42% of nursing colleges are present in five southern States whereas 17% in three western States.
• The nursing institutions are concentrated in Andhra Pradesh, Karnataka, Kerala, Tamil Nadu, and Telangana, while 17% are in the western states of Rajasthan, Gujarat, and Maharashtra.
• Only 2% of nursing colleges are in the north-eastern states.

Why India needs to focus on the issue?

• Backbone: Nursing services form the backbone of any medical establishment. Nurses play a critical role in health promotion, disease prevention and delivering primary and community care.
• Frontline: They are often the first to detect health emergencies and work on the front lines of disease prevention and the delivery of primary health care, including promotion, prevention, treatment, and rehabilitation.
• Key in achieving UHC: They provide care in emergency settings and will be key to the achievement of universal health coverage.

Possible Reasons of shortage:

• Lack of Infrastructure: As there is a skewed scenario for availability of nursing colleges there are limited seats for nursing in several states in India, which makes difficult for students to take the nursing courses.
• Health as a ‘State’ subject: Since Health is a state subject, the onus lies on the states to ensure that the optimum nurse-patient ratio is maintained. This has been compromised by the state government up to an extent.
• Gender biased profession: The nursing jobs are treated to be a gender biased occupation especially in India.
• Poor governance: The nursing and midwifery profession is witnessing a large-scale brain drain from the country due to poor salary, working conditions and absence of a proper career pathway, and out-dated systems of professional governance.

Concerns associated:

• Less Nurse-patient ratio: Due to lack of staff in the hospitals, patients are suffered for timely services.
• Health facilities compromised: Health facilities in a hospital get automatically compromised as staff members are unavailable or due to overburden of work.
• Corruption: The appointment of nurses is adding to the issue of corruption in nursing college for admissions due to less seats by officials.
• Harassment at workplace: As the less staff is available, hospitals are required to order their staff working for more time than normal employees, which creates frustration amongst the nurses.

Government interventions:

• The Centre has announced 157 new nursing colleges in co-location with the existing medical colleges established since 2014 for investment of Rs 1570 crore that would add around 15700 nursing graduates every year.
• Development of nursing services:100 crore has been allocated for the development of nursing services in the 10th five-year plan.
• In line with the World health Organisation’s (WHO’s) global strategy on “Human Resources for Health: Workforce 2030”, the Ministry of Health and Family Welfare (MoHFW) issued draft guidelines earlier this month to improve the working conditions of all categories of nurses in all healthcare institutions across India.
  • The WHO’s global strategy calls for a safe and healthy work environment for nurses in order to ensure quality nursing care.
    
    

Way forward:

• Incentivise the nursing staff: The government should provide nurses with personal protective equipment as required, free of cost, will fall on the hospital or clinic employing them.
• Open-up more colleges: There should be a central scheme for nursing colleges in every state and regulations must be scrutinised by an authority likewise for Medical colleges.
• Promote awareness to stop gender biasness for occupation: For India society, there is a need to spread awareness and campaigns regarding boys joining jobs of nurses by making ‘Nurse’ a gender neutral Term.