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India is set to face the biggest shortage of nurses in the world after Bangladesh, according to the World Health Organization (WHO), as many more of these health workers may have migrated abroad or have retired than government data suggests.

Thousands of migrant Indian nurses are battling the coronavirus pandemic in the US, UK and the Middle East, among other places, even as there is a shortage of such workers in India.

There are just 1.7 nurses per 1,000 people in India, according to Union health ministry data. That’s far less than the WHO’s prescribed minimum of 3. In March, the government told the Rajya Sabha that India has 3.07 million registered nursing personnel, including nurses, midwives and nursing assistants.

Experts, however, claim the government’s data doesn’t provide the true picture. “The numbers available with the government can be misleading as the Indian Nursing Council has not yet completed the live online registry. Nurses who have retired, died or are working overseas—all these categories may be part of available data," said Thankam Gomez, president, Association of Nurse Executives (India).

Nurses in India are overworked, underpaid and often undervalued, forcing thousands of them to migrate overseas every year in search of better-paying jobs. “Indian nurses are highly regarded in all countries outside India. This indicates that under better circumstances and experiential learning, our nurses can do a great job," she said.

The current health crisis has brought to the fore the shortage of nurses, Gomez said, adding that India’s woes may worsen if covid-19 cases surge.

An April report on state of the world’s nursing published jointly by WHO and the International Council of Nurses

(ICN) said that the availability of nursing staff could worsen as two major suppliers of nursing staff globally—the Philippines and India—are facing potentially significant “emerging shortages" within their own national health services.

“This is despite the fact that both countries train more health professionals than they need, in the knowledge that many will work abroad," said Howard Catton, head of ICN.

The Indian Nursing Council has recently proposed an exit exam for registration after studies for nurses. “We need to add skill-based competency assessment as well before a student nurse can practice as a registered nurse," said Gomez.

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