Strengthening pre-service education (PSE) for the nursing and midwifery cadre in India through an effective and scalable programmatic model

Background:There is acute shortage of competent nurse-midwives in India,with about 370,000 nurse-midwives currently available against the requirement of >1 million nurse-midwives.This shortage in numbers is compounded by sub-optimal levels of competency among existing nurse-midwives. Description:To address the challenge,Indian Nursing Council and Government of India,with support from USAID supported MCHIP project,has initiated a comprehensive initiative to strengthen the foundation of pre-service education(PSE)for nurse-midwives in India.Programmatic approach adopted includes implementing a set of simplified educational standards to establish five National Nodal Centers of excellence in India.These centers,besides serving as model teaching institutions,serve as pedagogic resource centers for nursing-schools of the states of their zones.The strengthening of PSE at select nursing schools in states of Jharkhand and Uttarakhand is being undertaken simultaneously under this initiative. Lessons Learned:There has been remarkable improvement in the standards of education at the schools since the implementation of this approach.The standards at ten targeted nursing schools in Uttarakhand and Jharkhand have increased from a mean baseline score of 31% to a mean endline score of 87%.Similarly the five nodal centers have shown improvement in educational standards from a mean of 53% at baseline to 88% at endline and clinical standards have improved from a mean of 16% to a mean of 84%. Recommendations:PSE for Nursing/Midwifery Cadre can be improved by implementation of simple quality improvement program model which uses a set of educational standards and customized training curriculum for clinical and teaching skills.This improvement is sustainable and scalable as there are minimal external inputs required for this initiative.