Today is the International Nurses Day. The nursing profession is indispensable in the health system. Nurses play a vital role in the treatment and recovery of patients. As a 93 per cent women-majority profession in a traditional society like Bangladesh where many women may not seek care for themselves or their children without access to a female health care provider, the nursing profession represents an opportunity to bridge understanding of women-specific problems and the peculiarities of their utilisation patterns. At the last mile (rural areas), urban slums and factories, nurses can be employed in telemedicine-enabled clinics to offer low-cost health care service.
As of January 2011, Bangladesh had 26,644 registered nurses with 17,605 posts in the public nursing services and education. Of them, 15,086 nurses work in the public sector and 2,513 posts are vacant. Vacancies in public sector posts are higher among nurses of higher qualification; 96 per cent of class 1 (senior) posts, 68 per cent of class II (junior) posts, and 20 per cent of class III (aide) posts are vacant. It is estimated that around 3,000 registered nurses are employed in the private sector, and about 3000 are working abroad. A study suggests that 99 per cent of nurses are employed in hospitals while another source suggests 95 per cent work in urban hospitals and clinics.
Bangladesh has a population-nurse ratio of 5000:1, a bed-nurse ratio of 13:1, and a doctor-nurse ratio of 2.5:1. These fall far short of the international standard for bed-nurse ratio of 4:1 and doctor-nurse ratio of 1:3. Thus, there is acute scarcity of nurses for providing inpatient care, where inadequacy of health care professionals (HCPs) is a strong limiting factor of population health. Also, with more physicians than nurses, the role of the nurse is very circumscribed, and doctors perform many tasks that nurses are qualified to do, either as a job preservation strategy or due to a lack of confidence in the capability of nurses.
Bangladesh faces a shortage of 280,000 trained nurses, which is a major obstacle towards achieving its MDG (millennium development goal) targets, as well as national health goals outlined under the 2011-2016 Health, Population and Nutrition Sector Development Program (HPNSDP) and the 2008 Bangladesh Health Workforce Strategy. In other words, a tenfold increase of the current size of the nursing workforce is needed.
Each year, public nursing institutes graduate 1250 nurses, while private nursing institutes graduate 530 nurses. This level of production is clearly inadequate to fulfill the current demand of trained nurses in the country without significantly increasing institutional capacity.
Two-year Accelerated BSc Nursing is a popular BSc Nursing programme offered in the western countries for the people who already have a Bachelor degree in any science-related field. Graduates from the non-science background can also enroll in the accelerated nursing course if they complete the necessary prerequisite courses in Biology and Organic Chemistry. Bangladesh Government and Bangladesh Nursing Council have recently approved the Two-year Accelerated BSc Nursing course curriculum. By offering accelerated BSc nursing course at the 37 government nursing institutes, with a yearly intake of only 100 students into the programme, Bangladesh can overnight increase the yearly net output of the new graduates from nursing institutes and college by another 4000 new nurses. This will bring the total number of new nurses entering service every year to around 6000. There are many young people in their 20s and 30s who might want to change their profession and chose nursing as their career because for a good nurse the profession is both prestigious and financially attractive. There is a huge demand for qualified nurses in the Middle East, North America, Europe, Japan and Australia. USA alone needs 1.5 million new nurses. If Bangladesh can send only 200,000 nurses to these countries for an average yearly salary of US$ 70,000 and if these nurses send home 50 per cent of their salary, it will amount to US$ 8.5 billion foreign remittance per year.
The writer is Executive Director of Good Health, Education, and Life (HEAL) Trust, a registered not-for-profit private organisation. tanvir@goodhealtrust.org