Abstract
Nurses comprise a key component to maternal and newborn health care delivery, including the care of ‘at-risk’ or sick newborns. However, the efficiency and effectiveness of services rely heavily on adequate numbers of highly skilled neonatal nurses. Currently, in India, a significant shortage of trained nurses in the field of newborn care is contributing to poor neonatal outcomes. Specifically, nurses caring for newborns lack the competency and experience needed to ensure optimal care. This deficiency has been linked to a lack of expert faculty, standardized training and minimal or no exposures to newborn clinical care areas during pre service education. Moreover, in addition to a lack of operational research in the area, nurses who provide care for newborns are often faced with numerous system related issues that impede their ability to provide optimal care. Most notably, frequent changes of work place, poor wages, and lack of continuing education, skill maintenance, recognition, and collaborative team culture further compromise the nursing care. All these lead to poor motivation and competency. To meet this challenge, it is essential that emphasis be placed on the identification and support of nursing faculty with expertise in newborn and neonatal care who are able to ensure that nurses receive standardized education for pre-service, in-service and ongoing care. In addition, importance should be placed on encouraging newborn nursing research as well as on governmental increases in salary compensation. Lastly, given the shortage of physicians to take care of sick neonates in remote areas, the creation of a cadre of Neonatal nurse practitioner/ advanced practice nurses would be an invaluable solution in developing countries. Furthermore, centralized oversight of newborn education and training would be best served, if responsibility was placed with Reproductive maternal newborn child health (RMNCH) workers and district level officers.
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References
National Population Policy 2000. Available from: http://india.unfpa.org/drive/NationalPopulation-Policy2000.pdf. Accessed 18 Apr 2014.
Sample Registration System. Estimates of Mortality Indicators. Available from: http://www.censusindia.gov.in/vital_statistics/SRS_Report_2012/11_Chap_4_2012.pdf. Accessed 23 Apr 14.
UNICEF. Human resources for facility-based newborn care in India issues and options: Available from: http://www.unicef.org/india/Policy_Brief_HR_SCNU.pdf. Accessed 16 Sept 13.
Statistics Division. Ministry of Health and Family Welfare Government of India. Family Welfare Statistics in India. 2011. Available form: http://mohfw.nic.in/WriteReadData/l892s/972971120FW%20Statistics%202011%20Revised%2031%2010%2011.pdf. Accessed 2 Aug 13.
UNICEF. Estimates developed by the UN inter-agency group for child mortality estimation. Levels & trends in child mortality. 2012. Available form: http://www.unicef.org/videoaudio/PDFs/UNICEF_2012_child_mortality_for_web_0904.pdf. Accessed 2 Aug 13.
Sinha K. National Development Council to discuss shortage of doctors, nurses. Times of India. [Internet] 2012 Dec 27. Available from: http://timesofindia.indiatimes.com/india/National-Development-Council-to-discuss-shortage-of-doctors-nurses/articleshow/17774481.cms. Accessed 18 April 2014.
Presidential Address by Guest of Honour, Mr T Dileep Kumar, President—Indian Nursing Council. Nurs J India. 2013;104(1). Available from: http://www.tnaionline.org/bifeb-13/7.htm. Accessed 18 Apr 2014.
Sinha K. India will need 2.4m nurses by ‘12: WHO. Times of India. [Internet] 2010 May 12. Available form URL: http://timesofindia.indiatimes.com/india/India-will-need-2-4m-nurses-by-12-WHO/articleshow/5918320.cms. Accessed 17 Sept.
Kumar TD. Unfolding the theme: preparation of nursing students for leadership role. Nurs J India. 2012; 103(1):23–5. Available from URL: http://www.tnaionline.org/feb-12/9.htm Accessed 18 April 2014 2013.
Bandyopadhyay NS, Malhotra S, Zodpey S, Mohan P. Challenges in scaling up of special care newborn units lessons from India. Indian Pediatr. 2011;48:931–5.
Fernandez A, Mondkar JA. Status of neonatal intensive care units in India: Available from URL: http://www.jpgmonline.com/article.asp?issn=0022-3859;year=1993;volume=39;issue=2;spage=57;epage=9;aulast=Fernandez. Accessed on 27 Oct 2013.
Sinha K. Plan panel mulls 2 nurses for every doctor. Times of India. [Internet] 2011 Oct 5. Available from: http://timesofindia.indiatimes.com/india/Plan-panel-mulls-2-nurses-for-every-doctor/articleshow/10237423.cms. Accessed 2 Aug 13.
Campbell-Yeo M, Deorari A, McMillan DD, Singhal N, Vatsa M, Aylward D, et al. Identification of barriers and facilitators for education of nurses in care of sick and at-risk newborn babies in India.: Available from: http://www.newbornwhocc.org/pdf/APW-WHO-SEARO-Shastri-Report.pdf. Accessed 27 Oct 2013.
WHO. Bulletin of the World Health Organization. Wanted: 2.4 million nurses, and that’s just in India. Available from: http://www.who.int/bulletin/volumes/88/5/10-020510/en/. Accessed 18 April 2014.
Indian Nursing Council. List of Colleges of Nursing for M. Sc (N) course recognised and permitted to admit students for the academic year 2013–2014. Available from: http://indiannursingcouncil.org/pdf/msc_16sept13.pdf. Accessed 17 Sept 2013.
Indian Nursing Council. List of Colleges of Nursing for B. Sc (N) course recognised and permitted to admit students for the academic year 2013–2014. Available from: http://indiannursingcouncil.org/pdf/bsc_16sept13.pdf. Accessed 17 Sept 2013.
Indian Nursing Council. List of schools of nursing for GNM course recognised and permitted to admit students for the academic year 2013–2014. Available from: http://indiannursingcouncil.org/pdf/gnm_16sept13.pdf. Accessed 17 Sept 2013.
Indian Nursing Council. List of schools of nursing for ANM course recognised and permitted to admit students for the academic year 2013–2014. Available from: http://indiannursingcouncil.org/pdf/anm_16sept13.pdf. Accessed 17 Sept 2013.
INC. List of colleges of nursing for P B BSC(N) course recognised and permitted to admit students for the academic year 2014–2015. Available from: http://indiannursingcouncil.org/pdf/pbbsc-04-04-2014.pdf. Accessed 18 April 2014.
INC. List of colleges of nursing for POST BASIC course recognised and permitted to admit students for the academic year 2014–2015. Available from: http://www.indiannursingcouncil.org/pdf/pbdp-04-04-2014.pdf. Accessed 18 April 2014.
Indian Nursing Council. Amendments for auxiliary nurses and midwives syllabus and regulation. Available from: http://www.indiannursingcouncil.org/pdf/Amendments-ANM-syllabus.pdf. Accessed 18 April 2014. Accessed 17 Sept 2013.
Indian Nursing Council. Syllabus and Regulations M.Sc. (NURSING). Available from: http://www.indiannursingcouncil.org/pdf/M.Sc.-Nursing-syllabus.pdf. Accessed 17 Sept 2013.
Government of India. Maternal Health Division. Guidelines for ante-natal care and skilled attendance at birth by ANMs and LHVs. Department of Family Welfare Ministry of Health & Family Welfare 2005; Available from: http://www.indiannursingcouncil.org/pdf/SBA-MODULE-Guideline-for-Antenatal-Care.pdf. Accessed 17 Sept 2013.
Pais M, Devi ES, Pai MV, Lewis L, Gorge A, Mayya SS, et al. Neonatal sepsis, bacterial isolates and antibiotic susceptibility patterns among neonates. Nurs J India. 2012;103:18–20.
Kachroo M. Effect of computer-assisted teaching programme on the knowledge of nursing personnel about pre-term labour and low birth weight. Nurs J India. 2012;103:65–8.
Thukral A, Sasi A, Chawla D, Datta P, Wahid S, Rao S, et al. Online Neonatal Training and Orientation Programme in India (ONTOP-IN)—the way forward for distance education in developing countries. J Trop Pediatr. 2012;58:486–90.
Geetanjli, Vatsa M, Paul VK, Mehta M, Srinivas M. Loss and grief response and perceived needs of parents with the experience of having their newborn at neonatal care units. Int J Nurs Educ. 2012;4:111–6.
Nirmala P, Rekha S, Washington M. Kangaroo mother care: effect and perception of mothers and health personnel. J Neonatal Nurs. 2006;12:177–84.
International council of nurses. Defining advanced practice. Available from: http://www.advancedpractice.scot.nhs.uk/definitions/defining-advanced-practice.aspx. Accessed 27 Oct 2013.
Acknowledgments
Authors are thankful to Dr. Praveen Kumar, Professor, Neonatal Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, and Dr. Shiv Sajan Saini, Assistant professor, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh for providing guidance and support.
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Kalyan, G., Vatsa, M. Neonatal Nursing: An Unmet Challenge in India. Indian J Pediatr 81, 1205–1211 (2014). https://doi.org/10.1007/s12098-014-1567-4
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DOI: https://doi.org/10.1007/s12098-014-1567-4