Nursing the nation: Policy must be in sync with practice
International Nurses Day is a timely reminder to celebrate nurses and push for structural reforms that empower the profession. In the spirit of the Prime Minister's call for women-led development, India's nursing workforce stands out as a living example of how a single profession can drive gender equity, economic advancement, and social progress—all at once.
The International Council of Nurses (ICN) has aptly chosen the 2025 theme: Our nurses. Our future. Caring for nurses strengthens economies. This theme underscores a growing global consensus—when we invest in nurses, we not only secure the health of our people but also stimulate economic resilience and gender parity.
With over 70% of India's nurses being women, nursing remains one of the largest conduits for women's participation in the formal workforce. India currently has approx. 1.96 nurses per 1,000 people, far below the World Health Organization (WHO)-recommended ratio of 3. To meet rising healthcare needs, estimates suggest India requires over two million additional nurses.
Nursing offers women more than just employment—it offers education, financial independence, and the dignity of purpose. It is a pathway to upward mobility, often in communities where opportunities for women are limited. The nurse's role today goes far beyond bedside care—she leads community outreach, advocates for patients, implements protocols, and navigates digital systems. These are the very qualities that define leadership.
Nurses contribute significantly to India's health care indices—supporting maternal and child health, managing non-communicable diseases, and strengthening rural access. Their impact directly advances the country's commitments under SDG 3 (Good Health) and SDG 5 (Gender Equality).
With the health care sector projected to reach $ 372 billion by 2025, nurses form the operational backbone—improving patient outcomes, reducing systemic strain, and enabling economic productivity through healthier communities.
While many nurses continue to face challenges like long hours, health risks, and unsafe workplaces, some institutions are setting new standards. Apollo Hospitals has implemented the Pink Book—a framework outlining tangible safety protocols such as panic buttons, staff-only zones, mental health support, and zero-tolerance harassment policies. These measures foster a workplace culture that prioritises dignity and protection.
Apollo has also launched a large-scale initiative to upskill thousands of nurses, covering clinical specialisations, leadership, digital fluency, and career mentoring. To support clinical staff further, the group has begun deploying AI-powered tools that reduce administrative burden—automating documentation, improving triage, and freeing up nurses to focus on care. Together, these interventions show how institutional leadership can align with ICN's global agenda in a local context.
While institutional best practices matter, structural transformation depends on robust policy backing. India's National Health Policy 2017 and Ayushman Bharat both acknowledge the need to strengthen the health workforce—yet bottlenecks remain.
To close the shortfall of over two million nurses, India must significantly expand nursing education, including through public-private partnerships that improve training quality and reach. Nurse practitioner and midwifery-led models must be fast-tracked to build advanced capacity in community settings. Equally, the National Nursing and Midwifery Commission Act (2023) must be implemented effectively across states, standardising accreditation and elevating clinical standards.
India must also create career progression pathways that enable nurses to move into leadership roles—not only within hospitals, but also in public health administration, health education, and digital innovation. State governments can partner with leading academic institutions to offer advanced certifications in areas such as geriatric care, mental health, and oncology nursing. These specialised roles are becoming increasingly essential with India's ageing population and rising non-communicable disease burden.
Moreover, investing in nurses' digital literacy is no longer optional. As health systems become increasingly tech-enabled, nurses must be equipped to use electronic health records, digital triage systems, and remote monitoring tools. With the right training, nurses can lead digital adoption at the last mile, particularly in rural and underserved regions where doctors are scarce but mobile networks are strong.
Financial and professional incentives—such as rural retention bonuses, housing assistance, and leadership fellowships—will be key to attracting and retaining talent. Most importantly, nurses must have a voice in policymaking. Their representation in health governance at the district, state, and national levels is essential to ensure that real-world caregiving challenges inform decisions.
India's health care goals—whether preventive care, universal access, or digital health—cannot be achieved without a strong nursing foundation. We must scale successful models, sustain investments, and ensure every nurse is equipped, protected, and respected.
Imagine nurses leading innovation labs, drafting clinical protocols, and shaping public health strategy. This vision is not aspirational—it is within reach, if we choose to prioritise nursing as a national imperative.
This article is authored by Dr Girdhar Gyani, director general, Association of Healthcare Providers (India).
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