I think the biggest challenges are:
1. Bureaucratic system of health system
2. Lack of involvement and being considered as individuals who can contribute in policy and in organisations that drive policy
3. Nurses themselves - unwillingness to mentor the younger ones, politics within the nursing fraternity, poor self image, unwillingness to showcase their competence, culture of submission
4. Lack of triune role of nursing faculty - clinical setting + education + research
5. CE although mandatory - do not ensure skills (clinical/advocacy/leadership roles)
6. Non-uniformity of recruitment, promotions, etc within the public and private health sector
7. Lack of recognition for role they take in health care
8. Poorly remunerated.
9. Come from backgrounds that are not so affluent, hence most strive to go abroad to meet their personal goals
The initiation of the health and wellness centers in the public health system I do hope will be the beginning of the rise of the nurse in India! Nurses are the key for delivering primary health care services in the country (https://ab-hwc.nhp.gov.in/) and hence could contribute towards leadership/policy/advocacy with the government
Thanks and warm regards
Maryann Washington (MSc-Child Health Nursing, MPhil -HHSM, PhD)
Prof-Nursing (non Tenure) Div of Epidemiology & Population Health
St Johns Research Institute
Bangalore 560034
India
