INDIA CALLS FOR MORE NURSES

In November 2022, renowned cardiologist Dr. Devi Shetty warned that India’s next major health crisis will likely be a shortage of nurses. In May 2023, Dr Girdhar Gyani, Director General of the Association of Healthcare Providers (India), said that although there are over 3.3 million registered nurses in India, this number is inadequate for a population of 1.3 billion. With only 1.96 nurses per 1,000 people, India falls short of the World Health Organization’s (WHO) recommended ratio of three nurses per 1,000 people. Even though India’s healthcare market is expected to grow to about $60 billion by FY 2028 and the sector is leading in women’s representation and advancement, these numbers show that there is still a lot of room for improvement in the nursing workforce.

“India has two nurses per 1,000 people as against the WHO recommendation of three nurses per 1,000 population. A well-trained nurse can alleviate the load on the doctors. India has a shortfall of about six lakh doctors. Compounding that with the shortage of nurses makes it a dire situation. This disparity highlights the urgent need for strategic interventions to raise the nursing workforce to improve healthcare outcomes,” said Jaideep Kewalramani, COO and Head of Employability Business, TeamLease Edtech.

The Covid-19 pandemic showed the strength of India’s nursing network and the crucial role nurses and health workers played in saving lives. The WHO also praised their hard work and selfless service, noting it contributed to India’s impressive recovery rate of 31.15 percent. However, despite having over 5,000 nursing colleges, India still faces a significant shortage of nurses, challenging the healthcare sector. “Nurses, not doctors, take care of the patients,” Dr Shetty said. Globally, the nursing shortage is a concern in many countries. WHO estimates a shortage of 4.5 million nurses and 0.31 million midwives globally by 2030.

“We are facing a nursing workforce and leadership shortage. The current nursing education model is not adequate to meet the needs of the future. The nursing shortage is also causing unprecedented burnout among nurses and many are experiencing decreased job satisfaction,” said Joseph Pasangha, Group COO, Sparsh Hospital.

Dr Bhawna Priya, assistant professor, IIM Raipur, believes the nursing crisis in India arises from low wages, poor working conditions, workplace safety concerns, limited career advancement opportunities, societal undervaluation of the profession, and inadequate mobility solutions in case of remote areas. “To attract and retain more women in nursing, I think raising salaries, enhancing working conditions, providing clear career progression paths, offering scholarships and incentives for nursing education, and improving the public image and respect for the profession are important,” she said.

Sardar Simarpreet Singh, Director of JIS Group, which has a nursing institute, also echoes similar sentiments. “We must also promote nursing as a prestigious career choice and provide support systems for nurses to balance their work and personal life,” he said.

There is a growing demand for nurses and health technicians across various healthcare settings, including government and private hospitals, primary care clinics, specialty clinics, long-term care facilities, and home healthcare. With India’s elderly population expected to reach 347 million by 2050, there is a pressing need for specialised nurses trained in elder care. Hospice care is another area where nurses can prosper, and there is a growing requirement for nurse practitioners in primary healthcare who can deliver services with the support of telehealth technologies.

In a report in 2021, WHO said Delhi had the highest density of nurses and midwives. In Bihar and Uttar Pradesh, both the density of doctors and the nurse-to-doctor ratios are very low. Moreover, the large-scale emigration of nurses to other countries creates a significant gap in addressing India’s healthcare needs.

“India’s demand for skilled nursing talent is on a trajectory, propelled by fast healthcare expansion. The demand for nurses globally has witnessed a significant surge over the past three years, recording an impressive 14-15% y-o-y increase in employment opportunities. Even India has been witnessing a substantial expansion in its healthcare infrastructure, with the establishment of new hospitals, clinics, and healthcare facilities across the country. The demand for skilled nursing talent is projected to increase by 17-18% by 2027,” said Ayanabh Debgupta, Jt. Managing Director, Medica Group of Hospitals. According to him, India’s crisis regarding nursing originates in the absence of nursing colleges matching with the increasing demand. “As far as the regions of nursing institutes are concerned, 42% institutes are in Andhra Pradesh, Karnataka, Kerala, Tamil Nadu, and Telangana, whereas only 2% institutes are in the North Eastern states. The above disparity in educational institutions affects the current and future numbers of aspiring nurses from other regions. Also, the expansion of nursing colleges is still below the proportionate growth of medical colleges. The only way for India to stall nursing workforce drain would be to focus on capacity building in education and training, fostering a supportive work environment for nurses, and implementing policies that promote retention and career advancement within the nursing profession. Indian government plans to build 157 new nursing colleges is a start in the right direction,” said Debgupta, who also believes the nursing curriculum needs a revival.

Healing hands

* India has more than 3.3 million registered nurses

* There are 1.96 nurses for every 1,000 people in India, says WHO

* India needs 4.3 million more nurses by 2024 to meet WHO norms

* WHO estimates a shortage of 4.5 million nurses and 0.31 million midwives globally by 2030

* Globally, 67% of the health and social workforce are women, compared to 41% across all employment sectors