Sindh Province: Transformation from Diploma to BSN

by Shabbir Hussain Jathial

In follow up of meeting held on 9th January, another consultative meeting with Vice-chancellors of five public universities held today in chairpersonship of Minister Health. Along with Department Officers, ex. President PNC Dr Rafat Jan, de facto President PNC Ms Afshan Amjad, Director Nursing Sindh, Directors/ Principals of Health Universities attended this meeting. I was called to assist the department as focal person for transformation/ affiliation & admissions in newly recognized nursing schools (public).

Breakthrough decisions were taken to expedite the transformation process thanx to the member of the PM Task Force Dr Rafat Jan & Dr Dabeer Ahmed (Dir. Plan & Eva.) for their special interest to assist health department to facilitate change in a smooth manner. It is heartening to see all major stakeholders together to achieve our cherished goals. Sindh will set an example in the transformation phase for sister provinces Insha Allah!

Working paper for the consultative meeting

Historically, the ‘Nursing’ had been considered as sub-part of Medicine thus, been treated as a subordinate addendum of Physicians and Surgeons’ administration. Consequently, it could not evolve itself like other health professions that, in course of time, opted for baccalaureate programs as a basic entry in service. Fortunately, this trend is under rapid change due to global effects on the evolution of nursing from ‘Diploma to Degree. The leading and facilitative role to embrace this transformation by Health Department Sindh, Higher Education Council (HEC), the Pakistan Nursing Council (PNC) and PM Task Force is well reflected in 27.9 billion PC-1 for uplift and up-gradation of Nursing and Midwifery in the province and across Pakistan.

Since last two decades, the awareness about nurses’ role as a parallel profession in tandem with medicine has been felt in both the services and education sector. Sindh province’s public and private sector institutes took the lead role in Pakistan Besides Aga Khan and other Universities, this province 05 Public Health universities have already started Degree program. The parallel status of Nursing in health care delivery and education can easily be observed in many institutes and hospitals having specialized nurses managing independently the units of care; and the Universities having BScNs, BSNs, Masters and PhDs as ‘Heads of their Nursing Institutes.

In this background a landmark decision letter from the Pakistan Nursing Council (PNC): PNC-F-11-Admin/2019/2319 dated 01.08.2019, reiterating therein that 2018 is /(was) last year of 03-years Diploma in General Nursing Course throughout Pakistan:

The said decision has been taken in line with the HEC’s Notification No.91/Nursing/Curric/HEC/14/220 dated 12.06.2015 and Government of Pakistan’s decision as approved by the Pakistan Nursing Council in its 24th Session-2019 and conveyed Vide PNC Notification No. F-7-184-Admin /2018/ 820-34 dated 19.03.2019 for implementation as; 3-Years General Nursing Diploma is stopped and no batch to be inducted after 2018. 

Consequently, no batch of Diploma in General nursing was inducted in the province’s 19 public sector nursing schools in 2019. The honourable Minister of Health and Population Welfare Government of Sindh, recently took direct initiative so to bring overall necessary changes in nursing education in its public sector schools as per national and international trends. In a meeting chaired by Honorable Minister some important decisions were taken so to immediately address the transformation challenge. In follow up of those decisions, this important meeting with the Vice-Chancellors of esteemed Public Universities is convened to chalk out an action plan of affiliation and admissions process on war footings to get students inducted to address the already acute shortage of nurses.

1. declare its 19 Diploma Schools as Degree Awarding Institutes (DAIs) to be affiliated by relevant Universities.
2. to post/transfer at least one faculty possessing MS Nursing to those schools having no MSN faculty posted to meet HR deficiency.
3. To process recruitment on vacant posts of Nursing/Clinical instructors and to create new posts.
4. Devise and notify the Admission Policy as per objective social and institutional requirements incongruence with PNC decisions.

To conduct a survey for need assessment of HR and infrastructure in existing schools. Following is progress so far from PNC of its public sector nursing schools under health department Govt. of Sindh:

Sr. No.	Name of School	PNC Status	Purposed to be affiliated with.
01	Male School of Nursing Jacobabad	Recognized for BSN	SMBBU Larkana
02	RBUT Hospital (SON) Shikarpur	Recognized for BSN
03	Civil Hospital (SON) Sukkur	Recognized for BSN
04	CMC Hospital (SON) Larkana	Under process
05	Male School of Nursing Larkana	Recognized for BSN
06	Liaquat University Hospital (SON) Hyderabad	Recognized for BSN	LUMHS Jamshoro
07	SON Sir CJ Institute of Psychiatry Hyderabad	Recognized for BSN
08	Civil Hospital (SON) Mirpurkhas	Under process
09	Civil Hospital (SON) Badin	Recognized for BSN
10	PMCH (SON) Nawabshah	Recognized for BSN	PUMHS Nawabshah
11	Civil Hospital (SON) Khairpur	Recognized for BSN
12	Civil Hospital (SON) Sanghar	Under process
13	Civil Hospital (SON) Thatta	Under process	DUHS Karachi
14	Dr. Ruth K.M. Pfau, Civil Hospital (SON) Karachi.	Recognized for BSN
15	Sindh Government Qatar Hospital (SON) Karachi	Under process
16	Male School of Nursing Sindh Government Hospital Liaquatabad Karachi	Recognized for BSN
17	Ayaz Samoon Nursing Institute Lyari Karachi	Recognized for BSN	JSMU Karachi
18	Male School of Nursing SG Lyari General Hospital Karachi	Recognized for BSN
19	Male School of Nursing Sindh Government Hospital Korangi No.5 Karachi	Recognized for BSN

It is also pertinent to mention that Rs.27.9 billion PC-1 named as ‘Strengthening and up-gradation of Nursing and Midwifery sub-sector within the health sector in Pakistan’- has envisaged transformation of Nursing Diploma to BSN Degree as cornerstone component. The related ‘CDWP’ meetings held in December 2019 and 02.01.2020 at Islamabad underlining a large chunk of resources for infrastructure development. On the directives of the Honorable Minister and the decisions taken for implementation, the health department has processed the following to make the transformation successfully:

• getting all its 19 nursing schools visited by PNC Inspectors for up-gradation,
• conducted a ‘need assessment survey’ to identify deficiencies needed for recognition. 

The scenario requires that Universities may facilitate the affiliation process of public sector nursing schools so that students could be inducted this year like the sister provinces. In the meanwhile, administrative and financial resources required will be implemented as decided by the department and envisaged in the PC-1 to be placed in ECNEC meeting very soon.