Short staffed, overburdened, undervalued: India's nursing deficit deepens

India Today

7 days ago

A critical shortage of nurses is emerging as one of the biggest challenges facing healthcare systems globally, and India is no exception. From hospitals to home care, the gap between demand and available staff is widening fast.A new report by the World Health Organisation (WHO) states that by 2030, the world is projected to face a shortage of 11 million health workers, including nurses.advertisementThis is an increase from the previous estimate of 10 million.
The WHO's State of the World's Nursing 2025, paints a concerning picture of global healthcare readiness.Almost 70% of this shortfall will hit Africa and the Eastern Mediterranean, but India, despite strides in health coverage, finds itself staring at a parallel crisis: an overburdened, undertrained, and rapidly thinning nursing workforce.While the global number of nurses rose to 29.8 million in 2023, the distribution remains alarmingly unequal. Developed nations, with just 17% of the world's population, employ nearly half of all nurses, leaving populous, low- and middle-income countries, including India, with deeply inadequate nurse-to-patient ratios.The global average stands at 37 nurses per 10,000 people, but in many parts of Asia and Africa, the figure is five to ten times lower.advertisementIn India, that imbalance plays out every day in hospitals, clinics, and elder care homes. The current nurse-to-population ratio of 1:670 is significantly below the WHO's recommended 1:300, and the situation is even more dire in geriatric care.
India, despite strides in health coverage, finds itself staring at a parallel crisis: an overburdened, undertrained, and rapidly thinning nursing workforce. (Photo: PTI)
India has around 150 million people aged 60 and above, a number expected to nearly double by 2030.Yet, according to Hoilenchong Sitlhou, senior nurse and geriatric care expert at Antara Care Homes, training and retention of skilled nurses remain key challenges."We are stretched thin. In senior care especially, where patients often require personalised attention and emotional support, inadequate nurse staffing can compromise both medical outcomes and human dignity," Sitlhou tells IndiaToday.in.Her insights strongly reinforce the WHO's call for urgent reforms. The report highlights that while 80% of nurses are now professionally trained, many lower-income countries, including India, lack the infrastructure, faculty, or standardised curricula to produce highly skilled nurses in critical areas like dementia care, palliative support, or chronic disease management.advertisementIndia's Certified Nursing Assistant (CNA) programs have opened doors for vocational entry, but as Sitlhou explains, these often fail to bridge the skill gap in high-need areas."Most CNAs don't get adequate hands-on training for geriatric or dementia care. Without structured upskilling or growth paths, they either stagnate or leave the system altogether," she says.
The current nurse-to-population ratio of 1:670 is significantly below the WHO's recommended 1:300. (Photo: PTI)
Even though the Indian Nursing Council has proposed reforms to standardise and strengthen curriculum, especially for geriatric specialisations, implementation has been uneven, and training remains heavily concentrated in urban centres."In rural areas, both patients and young nurses lose out. The few nurses trained in geriatric care end up migrating to cities or abroad," she adds.Migration is another key concern, both globally and for India. The WHO report warns that unless governments address poor working conditions, low pay, and lack of career progression, the "brain drain" of nurses will continue.advertisementIndia is a top exporter of trained nurses, with over 60,000 Indian nurses working abroad, drawn by better wages and safer, better-resourced environments."To retain nurses, we need competitive pay, better nurse-patient ratios, and a culture of professional respect. A single nurse managing five to six seniors with complex needs and no backup support, that's not sustainable. And it takes a toll on us too," said the senior nurse at Anatara.
India is a top exporter of trained nurses, with over 60,000 Indian nurses working abroad. (Photo: AFP)
At Antara Care Homes, a healthcare service providing at-home care for elderly patients, nurse-to-patient ratios are adjusted according to clinical need, ranging from 1:1 to 1:5.The organisation has also developed its own in-house geriatric training, accredited by the Healthcare Sector Skill Council, and partnered with Dementia India Alliance to roll out protocols in dementia care.These small pockets of excellence, however, remain the exception, not the rule.Nationwide, there is an urgent need for system-wide investment in nursing education and workforce planning. That includes adding more seats in nursing colleges, improving curriculum content, and creating pathways for continuous upskilling, especially in ageing-related health issues that are set to dominate India's healthcare landscape.
Nationwide, there is an urgent need for system-wide investment in nursing education and workforce planning. ()
advertisementThe WHO report notes that while the global stock of nurses may grow to 36 million by 2030, the inequity in distribution will persist unless deliberate, data-driven workforce planning is implemented.In India, the Nurses Registration and Tracking System, linked with Aadhaar, offers a real-time snapshot of nurse availability. But experts argue it must be leveraged more effectively to anticipate regional gaps and allocate resources proactively.Ultimately, both the global findings and ground-level experiences converge on one central truth: nurses are the backbone of healthcare. Whether in an ICU, a rural Primary Health Centre, or a dementia ward, they are often the first point of contact and the last line of care.Ensuring their well-being, training, and retention is not just a policy goal, it's a public health imperative.
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