Challenges and needed reforms in midwifery and nursing regulatory systems in India: Implications for education and practice
Challenges and needed reforms in midwifery and nursing regulatory systems in India: Implications for education and practice
Background
In India, nursing regulation is generally weak, midwifery coexists with nursing, and 88% of nursing and midwifery education is provided by the private health sector. The Indian health system faces major challenges for health care provision due to poor quality, indeterminate regulatory functions and lack of reforms.
Methods
We undertook a qualitative investigation to understand midwifery and nursing education, and regulatory systems in India, through a review of the regulatory Acts, and an investigation of the perceptions and experiences of senior midwifery and nursing leaders representing administration, advocacy, education, regulation, research and service provision in India with an international perspective.
Results
There is a lack of importance accorded to midwifery roles within the nursing system. The councils and Acts do not adequately reflect midwifery practice, and remain a barrier to good quality care provision. The lack of required amendment of Acts, lack of representation of midwives and nurses in key governance positions in councils and committees have restrained and undermined leadership positions, which have also impaired the growth of the professions. A lack of opportunities for professional practice and unfair assessment practices are critical concerns affecting the quality of nursing and midwifery education in private institutions across India. Midwifery and nursing students are generally more vulnerable to discrimination and have less opportunities compared to medical students exacerbated by the gender-based challenges.
Conclusions
India is on the verge of a major regulatory reform with the National Nursing and Midwifery Commission Bill, 2020 being drafted, which makes this study a crucial and timely contribution. Our findings present the challenges that need to be addressed with regulatory reforms to enable opportunities for direct-entry into the midwifery profession, improving nursing education and practice by empowering midwives and nurses with decision-making powers for nursing and midwifery workforce governance.
Midwifery, Nursing, Regulations, India, Public Health, Health Systems, Training, Education, Auxiliary Nurse Midwife;
1-18
Mayra, Kaveri
26fbb2ee-a058-46cf-a8cc-c527d88da0b5
Padmadas, Sabu S.
64b6ab89-152b-48a3-838b-e9167964b508
Matthews, Zoe
ebaee878-8cb8-415f-8aa1-3af2c3856f55
14 May 2021
Mayra, Kaveri
26fbb2ee-a058-46cf-a8cc-c527d88da0b5
Padmadas, Sabu S.
64b6ab89-152b-48a3-838b-e9167964b508
Matthews, Zoe
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Mayra, Kaveri, Padmadas, Sabu S. and Matthews, Zoe
(2021)
Challenges and needed reforms in midwifery and nursing regulatory systems in India: Implications for education and practice.
PLoS ONE, 16 (5), , [e0251331].
(doi:10.1371/journal.pone.0251331).
Abstract
Background
In India, nursing regulation is generally weak, midwifery coexists with nursing, and 88% of nursing and midwifery education is provided by the private health sector. The Indian health system faces major challenges for health care provision due to poor quality, indeterminate regulatory functions and lack of reforms.
Methods
We undertook a qualitative investigation to understand midwifery and nursing education, and regulatory systems in India, through a review of the regulatory Acts, and an investigation of the perceptions and experiences of senior midwifery and nursing leaders representing administration, advocacy, education, regulation, research and service provision in India with an international perspective.
Results
There is a lack of importance accorded to midwifery roles within the nursing system. The councils and Acts do not adequately reflect midwifery practice, and remain a barrier to good quality care provision. The lack of required amendment of Acts, lack of representation of midwives and nurses in key governance positions in councils and committees have restrained and undermined leadership positions, which have also impaired the growth of the professions. A lack of opportunities for professional practice and unfair assessment practices are critical concerns affecting the quality of nursing and midwifery education in private institutions across India. Midwifery and nursing students are generally more vulnerable to discrimination and have less opportunities compared to medical students exacerbated by the gender-based challenges.
Conclusions
India is on the verge of a major regulatory reform with the National Nursing and Midwifery Commission Bill, 2020 being drafted, which makes this study a crucial and timely contribution. Our findings present the challenges that need to be addressed with regulatory reforms to enable opportunities for direct-entry into the midwifery profession, improving nursing education and practice by empowering midwives and nurses with decision-making powers for nursing and midwifery workforce governance.
Text
journal.pone.0251331 (1)
- Version of Record
More information
Accepted/In Press date: 23 April 2021
e-pub ahead of print date: 14 May 2021
Published date: 14 May 2021
Additional Information:
Publisher Copyright:
© 2021 Mayra et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords:
Midwifery, Nursing, Regulations, India, Public Health, Health Systems, Training, Education, Auxiliary Nurse Midwife;
Identifiers
Local EPrints ID: 449300
URI: http://eprints.soton.ac.uk/id/eprint/449300
ISSN: 1932-6203
PURE UUID: 9cd87b2b-a39c-4599-9d29-ca0294196bb8
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Date deposited: 21 May 2021 16:34
Last modified: 17 Mar 2024 02:57
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