Challenges to Nursing Education in the Developing World

Tamoor Ilmas, BSc(hons). Currently studying a Masters in Public Health at the University of Eastern Finland.


In the 21st century, nursing practice worldwide is facing a wide range of challenges due to an ever-increasing population, an increase in the number of older and frail patients, escalating health costs and advancement in technology in health care systems. The complexity of these challenges is compounded by underlying shortages of nurses, a shortage of nurse educators and an ageing nursing workforce. There is an urgent need for continuous evaluation of nursing curricula and programs used to educate nurses.

For example, in India the major challenges to nursing education are a scarcity of faculty, increasing demand for specialized care, inadequate skill development and knowledge and a lack of collaboration between nursing services and education departments. Nursing education in Nigeria is also experiencing similar problems such a lack of management resources, scarcity in nursing scholars, poor professional development, little academic fellowships or scholarships, gender related issues such as perceiving nursing as a feminine profession, lack of equipment for teaching and learning processes, poor supervision by mentors and seniors and low support for self-directed learning. In Kenya, another developing country, there are similar challenges. These include a shortage of nurses, uneven distribution of nurses across the country, a lack of nurses with nursing degrees, a lack of infrastructure, inadequate equipment and low salaries for those with specialized education.

Bangladesh, one of the most densely populated and developing countries in the world is also facing many problems in the nursing field. There is a severe shortage of nurses with many more doctors than nurses. Other problems include a lack of nursing equipment, a poor nursing management system, lack of infrastructure, poor skills and professional development and no midwifery posts. In Pakistan there is a shortage of nurses and nurse to patient ratio is 1:50 whereas the nurse-patient ratio suggested by Pakistan Nursing Council is 1:10. There are less than the required institutes for nursing education and uneven distribution of nurses. Other problems include a lack of well qualified nurses, the perception of nursing as a low status job and a feminine profession, misbehavior of patients and family members with nurses and low wages. In Egypt similar problems abound including a shortage of nurses, lack of funding, lack of equipment, an uneven distribution of nurses in various health services, a lack of nursing faculty, low self-esteem and low status image of the nursing profession, low wages, an inadequate management system and difficulties in dissemination of new technical information. Similarly, in Sri Lanka the nursing profession is perceived as a low status profession. There is a poor nursing management system, poor infrastructure, scarcity in education facilities, lack of equipment and poor wages. Nurses have low self-esteem and a high turnover rate. The challenges to the nursing profession in Nepal include lack of knowledge regarding advanced technological equipment in health care, a gap between the nursing curriculum and practice, poor supply of teaching and learning aids, lack of promotional opportunities, inadequate working conditions, poor wages, lack of mentorship and poor involvement of nursing professionals in nursing administrative policies. Further information can be found in the links below.

Nurses are the back bone of the health care systems universally and play a vital role in providing health care services globally. In order to achieve universal health coverage, the nursing profession needs continuous and sustainable strength. The UK plays an important and leading role in strengthening the nursing profession across the globe particularly in developing countries by working in collaboration with allies in the Commonwealth, Europe and other international organizations such as the World Health Organization and World Bank, as these organizations have a major role in developing the nursing profession, nursing education and research. This initiative will help development of skilled nursing force, with the potential to be professionally equipped and well educated nurses and nursing leaders. Developing and strengthening nurses across the world will improve health, promote gender equality and economic growth.

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