Published Jul 24, 2026 | 7:00 AM ⚊ Updated Jul 24, 2026 | 7:00 AM
The World Health Organization's benchmark is three nurses per 1,000 population.
Synopsis: Parliamentary data reveal a stark regional divide in India’s nursing workforce, with Kerala, Karnataka, Andhra Pradesh and Tamil Nadu accounting for nearly half of the country’s registered hospital nurses. While India remains below the WHO’s nurse-population benchmark, northern and eastern states face severe shortages despite lower levels of overseas nurse migration.
South India has emerged as the country’s nursing powerhouse, with Kerala, Karnataka, Andhra Pradesh and Tamil Nadu accounting for nearly half of India’s registered hospital nursing workforce and recording some of the country’s highest nurse-population ratios, according to data tabled in Parliament.
A written reply by Union Health Minister JP Nadda in the Rajya Sabha on 21 July states that India had 46.02 lakh registered nursing personnel as of 31 December 2025, translating to a nurse-population ratio of 2.60 per 1,000 people.
“As per the Indian Nursing Council (INC) records, there are 46.02 lakh nursing personnel registered in the country as on 31st December, 2025, giving a nurse to population ratio of 2.60 nurses per 1000 population,” Nadda said in response to a starred question.
The figure remains below the World Health Organization’s benchmark of three nurses per 1,000 population, indicating that India continues to face an overall shortage of nursing personnel despite a growing workforce.
However, a closer analysis of the Ministry’s state-wise data reveals a striking regional imbalance. Southern states dominate the country’s professional nursing workforce, while many northern and eastern states continue to lag far behind.
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The Ministry’s overall figure includes three categories of nursing personnel: Auxiliary Nurse Midwives (ANMs), Registered Nurses and Registered Midwives (RN & RM), and Lady Health Visitors (LHVs).
Of the 46.02 lakh registered nursing personnel, 34.88 lakh are RN & RM, 10.59 lakh are ANMs, while about 55,000 are LHVs.
The distinction is important because RN & RM personnel form the core hospital nursing workforce, staffing intensive care units, operation theatres, emergency departments, labour rooms and inpatient wards. ANMs primarily serve in primary healthcare and community-based services, while LHVs supervise public health programmes.
Using only RN & RM registrations and UIDAI’s projected 2026 population estimates, India has 34,87,731 registered nurses and registered midwives, translating to 2.45 RN & RM personnel per 1,000 population.
Kerala leads the country by a considerable margin, reporting 3,79,090 registered nurses and registered midwives for a projected 2026 population of 3.62 crore. This translates to 10.47 RN & RM personnel per 1,000 population, more than four times the national RN & RM average.
Karnataka ranks second with 5,30,321 RN & RM registrations, the highest absolute number in India. Against a projected population of 6.89 crore, the state records 7.69 nurses per 1,000 population, combining both workforce scale and high nursing density.
Andhra Pradesh follows with 3,06,983 registered nurses and registered midwives, producing a ratio of 5.72 per 1,000 population, placing it fourth nationally despite having a much larger population than several higher-ranked northeastern states.
Tamil Nadu, home to the country’s second-largest RN & RM workforce after Karnataka, reports 3,94,405 registered nurses and registered midwives. Its larger projected population of 7.75 crore brings its ratio to 5.09 per 1,000 population, still more than double the national RN & RM average.
Together, these four southern states account for over 16.1 lakh registered nurses and registered midwives, nearly 46 percent of India’s RN & RM workforce, despite accounting for only about one-fifth of the country’s projected population. The data underscore South India’s central role in supplying nurses not only to its own healthcare system but also to hospitals across the country.
Outside South India, Arunachal Pradesh ranks third nationally with 6.81 nurses per 1,000 population, followed by Manipur (5.49), Himachal Pradesh (5.15), Punjab and Delhi (4.94 each), Sikkim (4.92) and Mizoram (4.91).
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Among the five southern states, Telangana stands apart.
The state reports 60,919 registered nurses and registered midwives against a projected population of 3.86 crore, producing a ratio of 1.58 nurses per 1,000 population. While this is above several large northern states, it remains well below the national RN & RM average of 2.45 and far behind its southern neighbours.
The contrast is particularly notable given Telangana’s rapidly expanding healthcare sector and Hyderabad’s position as one of India’s largest hubs for tertiary and corporate healthcare.
The data suggest that while southern India has broadly built a strong nursing base over the years, the region itself is not uniform, with Telangana trailing considerably behind Kerala, Karnataka, Andhra Pradesh and Tamil Nadu.
The dominance of South India becomes even more apparent when compared with several of the country’s most populous states.
Bihar records the lowest availability of registered nurses and registered midwives, with just 19,475 RN & RM registrations for a projected 2026 population of 13.22 crore, translating to 0.15 nurses per 1,000 population.
It is followed by Jharkhand (0.26) and Jammu and Kashmir (0.35). However, the Ministry notes that Jammu and Kashmir’s registration figures are available only up to 31 December 2021, meaning the actual number of nurses is likely to be higher than reflected in the current data.
The contrast is particularly evident in Uttar Pradesh, India’s most populous state. Despite reporting 2,34,174 registered nurses and registered midwives, the third-highest RN & RM workforce after Karnataka and Tamil Nadu, its projected population of 24.29 crore brings the ratio down to just 0.96 nurses per 1,000 population, well below the national RN & RM average.
Other large states also trail the national average. Assam records 0.97 nurses per 1,000 population, Odisha 1.11, Maharashtra 1.47, Haryana 1.50, and Telangana 1.58.
The figures suggest that while some states have expanded their nursing workforce in line with population growth, several others continue to struggle despite having substantial absolute numbers of registered nurses.
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The parliamentary reply also sheds light on India’s overseas nurse migration.
According to data provided by the Ministry of External Affairs, Kerala remained the country’s largest source of internationally migrating nurses, although emigration clearances have declined steadily, from 9,980 in 2023 to 8,572 in 2024 and 6,393 in 2025.
Tamil Nadu ranked second, recording 4,436 clearances in 2023, 3,736 in 2024 and 3,036 in 2025.
Migration from Andhra Pradesh also declined, falling from 225 to 195 and 149 over the three years. Telangana reported an even sharper decline, with emigration clearances dropping from 194 in 2023 to 140 in 2024 and 94 in 2025.
Karnataka’s overseas migration remained relatively stable, with 625 clearances in 2023, 610 in 2024 and 610 in 2025.
Among the major states, Jammu and Kashmir stood out as an exception. Unlike Kerala and Tamil Nadu, where overseas migration has slowed, the Union Territory recorded a steady rise in nurse emigration, from 354 clearances in 2023 to 474 in 2024 and 487 in 2025.
The migration data reveal an important trend. Kerala and Tamil Nadu continue to produce enough nurses to remain among India’s strongest-performing states despite sending thousands overseas each year. Conversely, states such as Bihar, Jharkhand and Uttar Pradesh, which have the weakest nurse-population ratios, do not feature among the country’s leading nurse-exporting regions. This suggests that workforce shortages are driven less by migration and more by limited nursing education, registration and workforce expansion.
Responding to concerns over nurses’ salaries and workplace conditions, the Centre reiterated that these largely fall within the jurisdiction of state governments.
“Health being a State subject, regulation of pay scales and working conditions of nurses employed in public as well as private hospitals/institutions primarily falls within the domain of the respective State/Union Territory Governments,” JP Nadda said in his written reply.
The Minister added that, following directions from the Supreme Court, “a Committee of Experts was constituted under the Chairpersonship of Director General of Health Services to look into the working conditions and pay of nurses working in private hospitals and nursing homes.”
According to the reply, the committee’s recommendations have been forwarded to all states and Union Territories and are reiterated periodically.
The analysis is based on Registered Nurses and Registered Midwives (RN & RM) reported by state nursing councils to the Indian Nursing Council and UIDAI’s projected 2026 population estimates. While the Ministry’s headline nurse-population ratio of 2.60 per 1,000 includes ANMs and Lady Health Visitors, the RN & RM analysis focuses on the professional hospital nursing workforce.
