India will need six million additional nurses by 2030 to meet rising healthcare demands, with a significant focus on addressing the growing need for newborn care, a recent study reveals.

"Neonatal mortality rates are highest in rural and resource-limited settings," the study published by Lancet reveals. "These challenges are compounded by inconsistencies in national standards and certification programs for neonatal nursing, preventing them from meeting international benchmarks."

The study finds a stark disparity between urban and rural areas. 

“Rural regions face severe shortages in nurse numbers and training resources, limiting their capacity to deliver high-quality neonatal care," the study adds.

States such as Bihar, Odisha, and Jharkhand experience "significant shortages of qualified neonatal nursing faculty”. Similarly,  urban centers like Delhi and Mumbai attract skilled educators, leaving rural institutions reliant on unqualified faculties.

"Faculty-to-student ratios can reach 1:45 in nursing colleges," the study points out. "This hinders individualized mentorship and hands-on training, essential for neonatal nursing." 

Barriers to Training

Uneven access to education programs hinders training of nurses in the country. For example, Rajasthan and Uttar Pradesh have fewer advanced training programs in neonatal nursing compared to states like Tamil Nadu and Kerala, the study highlights. 

"Nurses in rural and remote regions face significant barriers, including geographical isolation, financial constraints, and limited institutional support," says the study.

Lack of Clinical Exposure

The study bats for hands-on training for neonatal nursing students. 

“Clinical exposure is essential to develop practical skills, yet many programs lack sufficient training," the study says. "About one-third of Indian nursing students graduate without NICU (Neonatal Intensive Care Unit) experience. This limits proficiency in ventilator management, infection control, and emergency procedures."

Urban centers were found to offer better access to NICUs, but "rural and semi-urban areas fall short,”  with states like Kerala providing more consistent clinical exposure due to better healthcare infrastructure.

"Without swift interventions, India risks missing its national and global health targets for neonates," the study says. "This will further exacerbate health inequities across regions, leaving its most vulnerable population at risk."

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