title: Educational barriers of nurses caring for sick and at-risk infants in India.
abstract: To gain ideas and information from healthcare providers to optimize the education and clinical practices of nurses caring for sick or at-risk newborns in India.
  
  
  
  Improving infant survival has been identified as a Millennium Development Goals; however, India still faces many challenges with 3.1 million neonatal deaths and 2.6 million stillbirths annually. Skilled nursing care has been associated with decreased morbidity and mortality in newborns. However, core competencies in newborn care education and training are lacking for nurses.
  
  
  
  Qualitative data were collected from 12 focus groups with 101 newborn care providers from three areas of India as well as from a 2-day stakeholders' meeting. Data analysis was undertaken using descriptive and thematic content analysis.
  
  
  
  Perceived challenges included limited manpower and high nurse turnover, lack of access to evidence-based orientation to newborn care and problems with access to appropriate learner-based, neonatal training. Relevant, ongoing education opportunities, led by nursing leaders were identified to be important solutions.
  
  
  
  Findings provide insight into the current healthcare system in India with specific reference to the nursing care of at-risk newborns. There is a lack of existing resources to provide standardized and specific orientation curricula for nurses.
  
  
  
  Policy makers in health and education need to: support and enact learner-based orientation and continuing educational opportunities as well as ongoing competency-based education programmes; encourage nurse leader involvement and support; and provide sustainable system-related supports. Nurses and other health providers need to work together to influence government policy.
authors.affiliation: School of Nursing, Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada; Maternal Newborn Program, IWK Health Centre, Halifax, Nova Scotia, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Campbell-Yeo
authors.forename: A
authors.initials: A
authors.lastname: Deorari
authors.forename: D D
authors.initials: DD
authors.lastname: McMillan
authors.forename: N
authors.initials: N
authors.lastname: Singhal
authors.forename: M
authors.initials: M
authors.lastname: Vatsa
authors.forename: D
authors.initials: D
authors.lastname: Aylward
authors.forename: J
authors.initials: J
authors.lastname: Scotland
authors.forename: P
authors.initials: P
authors.lastname: Kumar
authors.forename: M
authors.initials: M
authors.lastname: Joshi
authors.forename: G
authors.initials: G
authors.lastname: Kalyan
authors.forename: J
authors.initials: J
authors.lastname: Dol
keywords: Education; Facilitators; India; Midwives; Neonatal Intensive Care; Newborn; Nurses; Training