Welcome to Directorate General of Nursing and Midwifery (DGNM)

The Directorate General of Nursing and Midwifery (DGNM) is the central body and focal point from which all activities relating to public sector nursing in Bangladesh are managed. This includes all involved in nursing and midwidery education and practices. Though regulation of nursing education and practice is the responsibility of the Bangladesh Nursing and Midwifery Council (BNMC), the BNMC works closely with the DGNM in regulating nursing and midwifery services.

The DGNM has similar responsibilities in terms of executive authority to other Directorates under the Ministry of Health and Family Welfare (MoHFW). The DNS is a member of most policy-making committees at national level relating to health services and education within the public sector.

The DGNM is one of the four current Directorates within the MoHFW. It is the highest body for managing the overall administration of public sector nursing services and education in Bangladesh. Its main responsibilities are:

• National nursing policy development and application
• Strategic and operational planning
• Operational plan delivery, budget management and procurement as required
• Nurse and non-nurse employee administration, including appointments, promotions, transfers
• Pre-service and in-service educational planning and management: Nursing Institutes and Nursing Colleges
• Planning and management of development projects
• Annual awards for best performance in nursing education and services
• Coordination with BNMC
• Collaboration and coordination with other directorates, Ministries, national and international organizations

The Director exercises the administrative authority of nursing and non-nursing workforce. Until today 19,034 posts are available within the control of the DNS. Of which 17,797 are for nursing and 1,237 for non-nursing personnel. Among them 14,589 nursing and 829 non-nursing personnel are working at present for different hospitals and educational institutions. However, the DNS enjoys the financial authority for only Nursing Institutes, DCECs and RTCs; and the DGHS allocates budget for Nursing personnel involve with hospitals/clinical services; and the MoH&FW is responsible for the College of Nursing, Mohakhali, Dhaka.
HISTORICAL DEVELOPMENT OF THE DIRECTORATE OF NURSING SERVICES

Pre-liberation (Before 1971):

Before partition nurses were being trained from three Junior Nursing Schools under the Bengal Nursing Council. The first professional Senior Nursing School was established in 1947 at Dhaka Medical College Hospital, Dhaka, and managed by few Sister Tutors, Sister and Staff Nurses from Madras and India. The post of Superintendent of Nursing Services was created at that time under the Ministry of Health, Pakistan. A British Nurse who was the Metron of Dhaka Medical College Hospital, worked as the Superintendent of Nursing Services. After partition of the East Pakistan, the Nursing Council was established and the Superintendent of Nursing Services became the acting Registrar of that Council.

In 1949 a group of nurses were sent to England for basic training, on return they were posted in leadership positions in the Nursing Service section. In 1950 the then Govt. offered fellowships to nurses for studying abroad. The WHO started their technical assistance on nursing in 1952, as a result the educational programmes were upgraded.

The East Pakistan Nursing Council was fully constituted in 1952 as a Regulatory Body for Nursing Education and Services. After liberation it was renamed as the Bangladesh Nursing Council (BNC). In 1956 the College of Nursing was established in Karachi to offer Post-basic Diploma in Administration and Teaching. Few nurses were sent over there to have those programmes. Later on selected nurses were sent to have B.Sc. and M.Sc. degrees from Boston University, USA, under the USAID fellowship programme.

In 1960 the Junior Nursing Training Schools were abolished and in between 1962 & 1970 the Senior Nursing Training Schools were established attached to 8 (eight) Medical College Hospitals to provide Diploma in Nursing and Midwifery. The College of Nursing, Mohakhali, Dhaka was also established in 1970 to offer Post-basic Diploma in Administration and Teaching. During 1970-1971 Senior Nursing Schools was further established attached to 12 District Hospitals and started crash programme without having any sanctioned posts for Sister Tutors, physical facilities and teaching- learning resources. The students, teachers and the teaching-learning resources had to be borrowed from other schools/ institutes to start these Schools. However, the number of nurses was increased at 600 in 1970 from 50 in 1947.

Post-liberation (Since 1971):

Prior to the creation of the Directorate of Nursing Services, the former Director of Health Services had managed the Nursing Education and Service Sector. There was a section headed by a Superintendent of Nurses in the Directorate of Health Services to look after the business of Nursing Education and Services. The Superintendent was a very Junior Officer in the Directorate of Health Services.

After liberation the number of Hospitals, Medical Colleges, Nursing Schools/Institutions; Doctors, and Nurses had been increased to meet the growing demands of health care services. In addition, many development projects were undertaken by the Government to meet the growing needs of the nation, but it was not possible for the then DGHS to give due attention required by the Nursing Sub-sector equally with Medical sector. Consequently nursing matters were delayed in being presented to the Ministry of Health & Family Welfare. The creation of the DNS was therefore mainly based on-

• to enhance Nursing Services; and

• to facilitate the speedy attention and required communication between the Ministry of Health and Family Welfare and the Nursing Directorate.

The Directorate of Nursing Services was therefore established on 14th May in 1977 under the Ministry of Health and Family Welfare, as the central body to run the nursing profession towards constituting a significant force in the health care delivery system congruent with national health goals (order No P-II/1C-18/77/391, dated 14/5/1977).

After the creation of a separate Directorate for the Nursing Education and Services, the Superintendent, who was the In-charge of Nursing Section in the Directorate of Health services (DHS), was appointed as the Director of the Nursing Services. Since the Superintendent of Nurses was a Junior Officer, she was not been appointed at the equivalent rank and status as the Director of Health Services or Family Welfare. She was given the rank and status at a considerably lower level. However, the creation of the DNS was a major shift from a small section to an independent Directorate. Though the rank and status of the DNS was supposed to be raised at that time, unfortunately no action has been taken yet. Consequently, the Directorate of Nursing Services remains in the rank and status at a much lower level than her counterparts in the Health and Family Planning. Later, the DHS became the Director General of Health Services and has many Directors unfortunately the Nursing Directorate remains unchanged, as it has not yet been upgraded.

GOAL & OBJECTIVES OF THE NURSING DIRECTORATE

The Nursing Directorate is the central body who enhances nursing services by leading the profession towards constituting a significant force in the health care delivery system for achieving the Goal `Health for All' congruent with the National Health Goals. Main aim is to make people healthier, productive and happier. In achieving the national health goals nursing professionals need to assist people for leading healthy life, having dignity and creativity, and behaving with a neighborly manner. Self-reliance among people will be the result by which they would take more active part in the society if they want to be healthy and happy.

In meeting the health related societal needs the Nursing Directorate plays the main roles and responsibilities in preparing and developing registered nurse and midwives who:

• will have up-to-date knowledge, attitude and skills in helping clients for-
• alleviating sufferings and recover quickly from diseases conditions/sickness;
• preventing communicable and non-communicable diseases; and
• rehabilitation.
• will have knowledge, insight and awareness about global issues and problems affecting the health of the nations (this should include the social/cultural, psychological and spiritual situation).
• will have the conceptual re-orientation about the holistic care of a patient/client with understanding of human interaction with the environment.
• must realize that s/he may not be called to do everything for the patient/client, but s/he must find out the necessary resources and must co-ordinate between the facilities required for caring patient/client.
• must ensure the implementation of nursing interventions and aim for achieving a successful outcome. As coordinator the nurse should be the guide of everybody from higher to lower.
• must work methodologically with quick assessment, planning, organizing, implementation and evaluation of the care of patient/client.
• must keep their professional knowledge and skills relevant and up-to-date through self-learning, in-service education, practice, higher education, and quality management including accountability. This would lead consumer satisfaction. A better image of nurses would logically follow when people in the society recognize the value of nursing care and that would result enhanced salary and status.