A literature review: the role of the private sector in the production of nurses in India, Kenya, South Africa and Thailand

Abstract

BackgroundThe demand for nurses is growing and has not yet been met in most developing countries, including India, Kenya, South Africa, and Thailand. Efforts to increase the capacity for production of professional nurses, equitable distribution and better retention have been given high strategic priority. This study examines the supply of, demand for, and policy environment of private nurse production in four selected countries.MethodsA scoping systematic review was undertaken to assess the evidence for the role of private sector involvement in the production of nurses in India, Kenya, South Africa, and Thailand. An electronic database search was performed, and grey literature was also captured from the websites of Human Resources for Health (HRH)-related organizations and networks. The articles were reviewed and selected according to relevancy.ResultsThe review found that despite very different ratios of nurses to population ratios and differing degrees of international migration, there was a nursing shortage in all four countries which were struggling to meet growing demand. All four countries saw the private sector play an increasing role in nurse production. Policy responses varied from modifying regulation and accreditation schemes in Thailand, to easing regulation to speed up nurse production and recruitment in India. There were concerns about the quality of nurses being produced in private institutions.ConclusionStrategies must be devised to ensure that private nursing graduates serve public health needs of their populations. There must be policy coherence between producing nurses for export and ensuring sufficient supply to meet domestic needs, in particular in under-served areas. This study points to the need for further research in particular assessing the contributions made by the private sector to nurse production, and to examine the variance in quality of nurses produced.

International migration of health professionals and the marketization and privatization of health education in India: From push–pull to global political economy

“…However, the increasing globalization of the health care sector in India problematizes a neat geographical distinction between 'core and periphery', since; "It is the advancement of health care in these countries that is, in effect, globalizing health care" (Crone, 2008, 117). Employing a North-South binary in terms of the directionality of HHR labour movements is also increasingly problematic because privatized healthcare has intensified service unevenness at all scales; local, regional and national (Smith et al, 2009;Reynolds et al, 2013).…”

Factors associated with the choice of public health service among nursing students in Thailand

“…In 2006, 19.6% of new nurses graduated from private nursing schools, and this increased to 24.1% in 2010 [17]. This shows the growing importance of the private sector’s contribution to nurse production in Thailand [14, 18]. …”

Challenges and Reforms in Midwifery and Nursing Regulatory Systems in India: Implications for Education and Practice

“…Midwives and nurses are recognized are often neglected and subjected to discrimination right from their PSE to all through their professional careers [6,7] . Indian nursing and midwifery education is faced with several challenges including resource constraints such as lack of teachers; a mismatch between theory and practice in learning; a lack of opportunities for practice; discrimination and stigma [2,[8][9][10] .…”

“…The training institutes are further skewed toward the urban areas within these states [6] . Regulatory mechanisms are reportedly relaxed to allow training in certain private institutes, despite capacity challenges [7] .…”