At the recent Global Rural Health Summit in Bengaluru, a powerful panel titled, ‘Empowering Nurses and Midwives for Rural Healthcare, Empowering Communities,’ brought together experienced nurses and midwives from states across India. These women shared stories of resilience, quiet leadership, and transformation. Their personal journeys revealed the strength and resilience that define their roles in rural healthcare.
Nurses and midwives are the backbone of India’s rural health system, keeping primary health centres running round-the-clock, leading immunisation efforts, delivering babies, handling emergencies, and reaching deep into communities with life-saving care. Yet, their realities are shaped by persistent challenges: long hours, limited support even from family and community, inadequate recognition, insufficient training and mentoring, and systemic exclusion from leadership spaces. From their reflections, the following themes emerged:
Nurses and midwives as custodians of compassionate healthcare
Often, nurses and midwives come from difficult circumstances, shouldering caregiving responsibilities within their households before taking up their positions on the frontlines.
“I come from a small town in Dungarpur (in Rajasthan, India). I was married before finishing school and had two children before I turned 20. After my husband passed away, I was solely responsible for my family,” remarked Chandra Bhanu Soni (Nurse Coordinator, Primary Health Centre Clinic, Udaipur, Rajasthan). During her Auxiliary Nurse and Midwife training, she was diagnosed with breast cancer, because of which she had to step away from the programme for treatment. “Two years ago, I faced ovarian cancer. After surgery and chemotherapy, I recovered—and now coordinate a primary healthcare clinic,” she said.
Despite these challenges, however, nurses and midwives are also caregiving leaders, performing tasks not taken up by other parts of the system. Many of their responsibilities, from patient interactions to counselling them on crucial preventive health measures such as vaccines, highlight the role of compassion in healthcare delivery.
This compassion, embodied by the frontline workers, was echoed in a word cloud of audience responses when asked what value comes to their mind when they think of nurses and midwives.
Dedicated training for improved care
In India, nurses and midwives have historically lacked access to mentorship and training resources in their careers. The panellists’ experiences highlighted the impact of dedicated training programmes for improved quality of care and patient interactions, in the hospital and health centres where they work.
“I worked on an eighteen-month midwifery program where we developed a curriculum based on global standards. This initiative influenced the government’s decision to invest in a dedicated midwifery program,” said Inderjeet Kaur (Director Midwifery, Fernandez Foundation, Telengana, India). Gradually, she noted, changes began to occur, with the state government of Telengana recognising the need to train midwives to enhance quality care and establish a professional cadre. The transformation was particularly visible in the midwives’ interactions with women in labour rooms.
“Before the training, I would not talk much to the women coming to my primary health centre,” remarked Mallika (Midwifery Educator, College of Nursing, Guntur, Andhra Pradesh). “After the training, I started talking to them more. Women now started flocking to me, something that did not happen earlier. I now try to pass on my learnings to my students.”
Unravelling hierarchies, empowering community leaders
Nurses occupy a unique position, serving as crucial links between healthcare systems and the communities they serve. Despite this, however, they do not have access to key leadership roles.
“I have visited many states in India. There are hardly any nurses in the administrative positions and all decisions concerning them are taken by someone else. We need many more nurses in leadership positions,” noted Evelyn Kannan (Secretary General, Trained Nurses Association of India).
Their experiences also shone light on how unravelling rigid workplace hierarchies and empowering nurses as decision makers boosts their confidence and can be life-saving in exigent conditions.
“We all—our doctors, nurses, other team members, always sit together on the floor for our meals. There is no senior or junior, we are all equal,” shared Chandra Bhanu, adding that “We work as a team, whenever a sick patient is brought in, all of us come together.”
“Once a woman came with a serious condition, and a nurse made the diagnosis. She had the authority to diagnose, and the doctor accepted her decision,” said Prema S. (Nursing Superintendent, Secondary Care Hospital, Tamil Nadu). “Trusting nurses not only builds their capacities but also helps in gaining the trust of the community.”
These powerful stories revealed that quality care begins with empowering caregivers—investing in their training, knowledge, and confidence to serve communities. It means showing them respect, not just in words, but in policy and daily practice, fostering teamwork so they are never alone in the face of challenge, and trusting their judgment as the first responders.
When nurses and midwives are supported to lead, grow, and be part of the decisions at primary health centres and hospital at the state and national levels, they not only thrive, but also transform the communities they serve.
