Impact of planning commission and NITI Aayog initiatives for transforming nursing education in India: a historical–policy review

Nursing education is a critical determinant of health system performance, workforce preparedness, and quality of care, particularly in countries pursuing universal health coverage. This historical–policy review examines the impact of national planning and strategic policy initiatives on the evolution of nursing education in India, with specific focus on the transition from the Planning Commission–led Five-Year Plan framework to the contemporary reform agenda guided by NITI Aayog. Drawing on a systematic synthesis of peer-reviewed literature, government policy documents, statutory regulations, and grey literature published between 1950 and 2025, the review analyses how planning priorities, regulatory mechanisms, and programmatic interventions have shaped nursing education capacity, quality, and governance. The findings indicate that early planning efforts primarily emphasised quantitative expansion of training institutions and workforce numbers, with limited attention to curriculum relevance, faculty development, and competency outcomes. The scale-up of services under the National Health Mission exposed these gaps, prompting targeted initiatives to strengthen pre-service education and regulatory oversight. More recently, NITI Aayog has introduced a strategic, systems-oriented approach that recognises nursing education as central to health system transformation, advocating competency-based curricula, decentralised district-level institutions, integration of midwifery and advanced nursing roles, and use of digital learning platforms. Despite these advances, persistent challenges remain, including uneven quality across institutions, faculty shortages, regulatory fragmentation, and weak monitoring of education-to-workforce outcomes. Overall, the review highlights that sustained policy commitment, regulatory modernisation, and evidence-informed implementation are essential to translate strategic intent into meaningful improvements in nursing education and workforce readiness in India.