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Feature Workforce planning

Can India end the corruption in nurses’ training?

BMJ 2013; 347 doi: (Published 18 November 2013) Cite this as: BMJ 2013;347:f6881
  1. Soumyadeep Bhaumik, medical doctor, independent researcher, and freelance author, Kolkata, India
  1. soumyadeepbhaumik{at}

India needs more and better nurses if it is to achieve universal health coverage, and for that must raise the standard of training. Soumyadeep Bhaumik reports on the unethical practices that are holding it back

The World Health Organization has called for universal “access to a skilled, motivated and supported health worker, within a robust health system.”1 But a review commissioned by the UK Department for International Development in 2009 found major shortcomings in nursing in India in terms of quantity and quality.2

“The overall quality of nursing care in India is not up to the mark,” agreed Usha Ukande, principal of Choithram College of Nursing, Indore, and president of the Nursing Research Society of India.

The severe shortage of nurses of all categories and at all levels, the overburdened health system, and deficiencies in infrastructure, compounded by nurses being overworked, underpaid, and exploited are some reasons.3 But quality in any profession depends on education and training.

Workforce planning is not centrally coordinated in India. The federal government publishes statistics and guidelines but state governments and private hospitals can choose how they respond.

Quantity over quality?

The central government has asked all states to invest in more training institutions to increase the numbers of general nurse midwives, auxiliary nurse midwives, as well as nurses trained in super-specialty disciplines, and it has provided subsidies to help.4

“Recent plans for universal health coverage in India have been developed on the expectation of a principal role for nurses, as the backbone of public and essential health services and majority contributors to the health workforce,” Kabir Sheikh, senior scientist and director at the health governance hub of the Public Health Foundation of India (PHFI), told the BMJ.

In the past, predictions of shortages of nurses have led to new training institutions being …

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