There is an urgent need for setting up fully functional Nursing Directorates across the country to strengthen nursing and midwifery as a profession and formulating equitable and fair policies to reduce policy-practice gaps in the healthcare system.
According to Smritikana Mani, OSD, Nursing Session, Directorate of Health Services, West Bengal, establishing nursing directorates across states is a prerequisite to strengthen nursing and midwifery as a profession and empower the professionals to play a pivotal role in the mitigation of health crises that may emerge in the future. It will give nursing personnel more powers and autonomy, enabling them to take up leadership roles at the policy level facilitating institutional reforms and increasing the credibility of nursing profession.
“West Bengal is currently the only state in India where there are about 17 nursing officers dedicatedly looking after the administration of nursing education, practice, career path and working conditions. As a result, the workforce has increased from 3,000 nurses in 1957 to 66,983 in 2022. The success of West Bengal nursing cell has made it evident that creation of separate nursing directorates led by nursing leaders across India can go a long way in raising the status of nursing profession in the country,” Mani told BusinessLine.
Limited involvement in policy making
Nurse midwives form the cornerstone of healthcare delivery in the country. The WHO Global Strategic Directions for Nursing and Midwifery 2021-2025 presents a evidence-based practices and an interrelated set of policy priorities helping them contributing optimally to achieve universal health coverage and other population health goals.
However, while nurses enjoy a majority in the health task force, they remain starkly absent from leadership roles in the healthcare sector either due to non-sanctioning of the nursing positions or non-filling of the positions. Additionally, the limited involvement of nurse midwives in the policy/decision-making levels has deterred the formulation of equitable and fair policies to reduce policy-practice gaps in the healthcare system. Hence, a much-needed representation of the nursing workforce in leadership roles is required, including setting up of fully-functional nursing directorates, she said.
The directorate of nursing is the central body from which all activities relating to nursing and midwifery are managed. This includes all activities involving nursing and midwifery practices, providing primary health care as well as fulfilment of the third Sustainable Development Goal in order to achieve reduction in maternal and child mortality, besides other specialities targeted at achieving good health and well-being.
Today, there is an urgent need to strengthen them to increase the representation from the Nursing and Midwifery cadre. In states, where there is neither a fully functional Nursing Directorate nor the post of Director Nursing, the final decision-making powers rest with non-nursing personnel. Hence, the involvement of nurse midwives is limited in health and nursing related policy and decision making.
India currently has over three million registered nurse midwives, responsible for nearly 1.3 billion population, which is a grossly inadequate ratio. This is less than the WHO norm of three nurses per 1000 population. To meet the prescribed WHO norm, India needs to add more than 4.3 million nurses by 2024.
The lack of nursing reforms has translated in shortage of manpower in both teaching and service delivery setups. Creating more administrative and leadership positions with decision-making powers by placing more nurse midwives in leadership positions will have a strong influence on the creation and strengthening of the cadre, she added.