Submit your Article

Sending Nepali nurses to the United Kingdom will worsen Nepali medical sector, affecting the health services, health experts have warned.  

The shortages of nurses in the country will have an adverse effect in the health sector as patients will face delays in emergency departments and in other health services. 

 Critical care will be affected and there will be scarcity of nurses to take care of patients after surgery. Also it increases the workload of the nurses and makes them fatigued.  

Nepal and the United Kingdom though have signed a bilateral agreement on health partnership opening the door for Nepali nurses to work in the UK. 

There are already international concerns over the UK’s plan to take nurses from developing countries. The International Council of Nurses (ICN), said that such wealthy nations recruiting nursing staff from some of the world’s most fragile health systems was extremely hard to justify and perhaps should be stopped entirely. 

The ratio of nurses to the British population is around 80 to 10,000 while in Nepal it is nearer 20. The government run hospitals where there are a large number of the patients are facing an acute shortage of nurses. 

Consider this case. Recently 245 nurses have been appointed in Bir Hospital and 50 nurses have been appointed to work in federal governmental hospitals. These newly appointed numbers however are still insufficient to deliver quality health care to patients.  The ICN has said seven or eight wealthy countries—notably Britain, the United States, and Canada—were driving around 80 percent of international nurse migration, to try to address their domestic shortages.

Situation of nurses in the country 

The country is already facing an acute shortage of nurses. The shortage of nurses affects health care services, posing a threat to patient’s lives. It affects patient satisfaction rate, increases medication errors and makes them fatigued. 

One nurse should serve only six patients in a general ward, four in a pediatric unit, and one in an intensive care unit with a ventilator, according to the government. It is also ideal to have at least two nurses for a single operation table and during delivery.

Nepal produces around 5,000 nurses per year and this number is insufficient to the country. The number of nurses in the health centers in the rural areas are lesser than the urban areas.  According to Nepal Nursing Council there are 1,352 specialist nurses, 73,889 nurses, 51 midwives, 37,236 auxiliary nurse midwives and 848 foreign nurses registered with the council.

The World Health Organization estimates that at least 2.5 medical staff (physicians, nurses and midwives) per 1,000 people are needed to provide adequate coverage with primary care interventions as per its World Health Report 2006.

There is a need for 70,000 nurses in the country itself. 

The country however has not been able to meet the WHO estimates. Nepal is currently on the red list of countries according to the Code of Practice. The Code of Practice for the ethical international recruitment of health and social care personnel bans active recruitment from countries with the greatest workforce shortages unless there is a government-to-government agreement in place.

“When the government is not concerned about the shortage of nurses in the country and is sending the human resources to foreign countries it’s a shameful situation,” said Sarala KC, president of Nepal Nursing Council.

She said that this decision will be counterproductive as it affects the health care system. “Its effect will be seen in the citizens as they will not be able to get healthcare. When there is a shortage of the nurses the hospitals will be closed,” KC added. 

Who is eligible? 

Though the two governments are still working to prepare an implementation protocol Nepali citizen aged between 20 and 45 and who have completed either Staff Nurse, Bachelor’s Degree in Nursing Bachelor of Science in Nursing (BSc), or Bachelor of Nursing (BN), or Master’s Degree in Nursing, holds an active professional license from the Nepal Nursing Council plus at least two years of experience in a registered hospital in Nepal is eligible for the application. The applicants can fill up an online application on the Department of Foreign Employment’s website. 

Details on the recruitment process, the initiation date for the application process, as well as other related information will be posted on the Ministry’s website. The ICN has said that international recruitment focused largely on experienced, specialized nurses, rather than the “myth” that only newly-qualified nurses were being targeted.

“That creates a serious deficit in expertise in countries that cannot afford to lose their more experienced nurses. That has really been a serious concern,” ICN president Pamela Cipriano, had said during a press conference organized by the UN correspondents association in Geneva. 

British ambassador to Nepal Nicola Pollitt after signing the agreement on 22 Aug last year had then tweeted that the deal will benefit the health sectors of both countries.  Successful Nepali nurses will not need to pay anything for the recruitment and will enjoy the same benefits as British nurses, Pollitt, she had said.

The medical experts however are of the view that sending the Nepali nurses will worsen the condition of the already ill health sector. They say that the number of nurses is already decreasing in the country as the number of nursing colleges and the number of students joining nursing education is declining. “We must increase the number of nursing students if we are to run the medical sector,” said KC. 

Over 250,000 medical resource needed 

The Medical Education Commission (MEC), a national regulatory body for medical education in Nepal estimated that more than 250,000 human resources related to the medical sector will be necessary in the country till the fiscal year 2030/31. The projection has been made on the basis of a study based on fiscal year 2020/21. 

The commission has said that a total of 358,938 human resources including female health volunteers and office assistants in both the government and private health institutions would be needed across the country. It has also said that there is a demand of 257,091 doctors and health workers in the Nepali medical sector. 

“The number of human resources are projected on the basis of the retirement and migration of the health practitioners along with the construction of health institutions in the country,” said Dr Shree Krishna Giri, vice-chair of the commission. 

With the emergence of agile development approaches, the software delivery landscape has transformed dramatically. Gone are the days of monthly or bi-monthly releases; now, mobile apps and softwares undergo weekly or bi-weekly updates. To keep pace with these frequent releases, continuous testing has become the norm, aided by automation suites for sanity and regression testing. However, as digital transformation takes centerstage, the need for scalable and predictive systems that anticipate market requirements becomes paramount. This shift necessitates a move beyond continuous testing and toward leveraging artificial intelligence (AI) to enhance quality assurance practices.

Quality management methods have undergone significant changes over the years to adapt to changing software development and delivery approaches. Today, continuous testing, driven by Agile and CI/CD methodologies, dominates the Quality Assurance (QA) landscape. However, this approach presents its own challenges, including siloed automation, lack of end-to-end requirements visibility, and managing a high volume of tests. To overcome these hurdles, the industry is now embracing autonomous testing, which ensures zero-touch QA.

Traditional software testing is time-consuming and prone to human errors. A growing number of tests and the need for comprehensive code coverage add to the complexity. AI offers a solution by accelerating the testing process and automating test suite generation. AI agents can learn and adapt throughout the testing process, identifying errors and bugs that may be missed by traditional tests. AI-powered visual verifications enhance testing accuracy, and techniques like image-based testing, AI spidering, and API monitoring further augment QA efforts. The benefits of incorporating AI automation into quality assurance practices are manifold. Firstly, it significantly reduces testing time, enabling faster time-to-market. AI-powered testing tools provide enhanced test coverage, delivering accurate results with expedited turnaround. By automating repetitive tasks, QA teams can focus on more complex and strategic aspects of testing. Moreover, AI-based testing ensures better code coverage, improved accuracy, and reduced costs compared to manual testing.

AI is revolutionizing the field of quality assurance, enabling organizations to navigate the rapidly evolving landscape of software development. From automating testing processes to enhancing test coverage and accuracy, AI-powered tools and techniques are reshaping the QA industry. As the future unfolds, the role of AI in quality assurance will continue to grow, enabling experimentation-driven testing and empowering QA specialists to deliver high-quality software with efficiency and precision. Embracing AI in quality assurance is not just an option but a necessity for organizations aiming to stay competitive in the digital age.

In today’s rapidly evolving technological landscape, businesses are increasingly turning to AI to optimize their QA and testing processes. AI-powered testing tools offer a range of benefits that enable testers to transition from manual testing to automated, efficient, and accurate continuous testing. This article explores the advantages of utilizing AI in QA and testing, highlighting how it can expedite timelines, facilitate well-researched build releases, streamline test planning, expand the role of testers, enable predictive analysis, improve the writing of test cases, enhance regression testing, and revolutionize visual user interface testing and defect tracing. One of the key benefits of using AI in QA and testing is the significant reduction in testing time. AI-powered tools can swiftly scan codes, log files, and databases, identifying errors and discrepancies in seconds. Unlike human testers, AI does not experience burnout and consistently delivers precise and accurate results. Additionally, AI can adapt to code changes and identify new functions, distinguishing between new features and bugs resulting from code modifications.

By leveraging AI in QA, companies can analyze successful apps and software in the market, gathering insights into what contributed to their success. This knowledge can be used to create new test cases that ensure the app or software meets specific goals and remains stable under different scenarios. Traditional test planning involves significant manual effort, with QA experts spending considerable time creating test case scenarios for each new version release. AI QA automation tools simplify this process by automatically analyzing the app or software, crawling through every screen, and generating and executing test-case scenarios. This automation saves valuable planning time and improves efficiency.

AI in QA and testing necessitates testers to acquire new skills in neuro-linguistic programming, business intelligence, math optimization, and algorithmic analysis. As AI takes over repetitive tasks and data analysis, testers can focus on higher-level tasks such as interpreting results, making strategic decisions, and ensuring optimal user experiences. AI-driven QA enables the analysis of existing customer data to predict evolving user needs and browsing patterns. Testers, designers, and developers can proactively anticipate user expectations and deliver better-quality support. Machine learning algorithms enable the AI platform to continuously improve and provide increasingly accurate predictions based on analyzed user behavior. AI improves the quality of test cases for automation testing. With AI, developers can quickly analyze project data and identify new approaches to test cases. Traditional methods often overlook additional possibilities for test cases, while AI-driven analysis enables the discovery of new and efficient ways to test software.

The rapid deployment of software necessitates thorough regression testing, which can become overwhelming for manual testers. AI can be employed to handle tedious regression testing tasks, utilizing machine learning to create test content and identify changes in UI elements, such as color, shape, or size. AI ensures that even minor UI modifications are thoroughly validated. AI facilitates better user interface design and visual approval of website pages. AI testing tools can analyze different elements on the user interface, enabling tests that would typically require human intervention. Machine learning-based visualization tools can detect minute differences in images that humans might miss, simplifying tasks such as updating the Document Object Model and reducing the risk of errors.

In traditional manual testing, bugs and errors can go unnoticed for extended periods, creating challenges in the future. AI in software testing automates defect tracing, quickly identifying and pinpointing flaws. AI-based bug tracking detects duplicate errors and recognizes patterns of failure, allowing the development team to operate smoothly.

The benefits of incorporating AI in QA and testing are numerous, revolutionizing the way companies approach software quality assurance. From expediting timelines and enabling well-researched build releases to facilitating effortless test planning and enhancing defect tracing, AI-driven tools and platforms empower testers to deliver high-quality software efficiently. By embracing AI in QA and testing, businesses can optimize their testing processes, improve customer experiences, and gain a competitive edge in the dynamic digital landscape.

The author is a leading consultant on Data Analytics, QA Testing. Views expressed are personal

Udita (name changed), who often works from home, had an important work presentation on the first day of the week. She was both nervous and anticipative about the meeting. She had 25 minutes before logging in to the video conferencing app when her mother showed up in her room and asked her to join her for lunch. Udita told her mom she would eat later since it was almost time for her meeting. Her mom got upset no sooner and said, “It seems like all the other people at my home have important work to do; only I am the free and useless one here.” Those words got to Udita’s nerves, and she frowned, “Not again!” before turning to her presentation. Her mom stormed off.

In situations like these, acting from a self-focused mindset can be easy, which drives us to see other people as objects. Perhaps, Udita’s mom must have other commitments to look into after finishing lunch, so when Udita didn’t agree to join her, she started seeing Udita as an obstacle in her way of getting things done. As for Udita, she had an important presentation, so when her mom didn’t take her request positively, she possibly started perceiving her mom as an irrelevancy to ignore.

Udita had a few minutes before the presentation, but her mind constantly flashed back to her interaction with her mom. She, in fact, quickly realized that she was slipping into a self-focused mindset toward her mom. She knew she couldn’t continue if she wanted her presentation to go well and not worsen the relationship with her mother.

Udita soon recalled what she had learned about the three modes of applying the impact-focused mindset, instead-Self-Connection, Honest Self-Expression, and Empathic Connection.

Self-Connection

Self-Connection is about connecting with our feelings and needs rather than getting stuck in a cycle of blaming and justifications. Through this mode of Impact-focused mindset, we hold space to acknowledge what’s going on for us.

We can ask the following questions to connect with ourselves:

-What really happened?
Udita separated her judgments from what happened in the situation factually. She redirected her thoughts to what she heard and saw in the interaction with her mom. She recalled that her mom told her, “It seems like all other people at my home have important work to do, only I am the free and useless one here,” to which she responded, “Not again!”

-How do I feel?

Udita checked in with herself and realized she felt annoyed and discouraged upon hearing her mom’s words.

-What do I need?

With a self-focused mindset, it might have been easy for Udita to believe that her mother caused her feelings of annoyance and discouragement. The truth is that her mother’s words and actions only triggered those feelings in Udita. Her feelings emerged from her unmet needs for support and understanding, which she sought in the relationship with her mother.

-Do I have a specific request for myself or someone else?

Udita then realized she perhaps needed to focus on doing the presentation well for now. After the presentation, she decided to have a conversation with her mother. 

Empathic Listening

After Udita got off her meeting, she approached her mom and invited her to share how she felt. Although it did seem that the earlier incident still gripped her mom, she shared how she was disappointed and overwhelmed by her family members’ overlapping schedules. She expressed how she felt disconnected and all over the place. Udita could sense and understand that perhaps her mom had unmet needs for connection, certainty, and order. Instead of just assuming her mom’s needs, Udita asked if she had identified her needs correctly. Her mom confirmed and felt slightly relieved upon being understood.

Honest Self-Expression

After listening to her mom, Udita told her mother how she felt and what she needed (which she identified through Self-connection). She explained why she couldn't promptly act on her mom’s request. She had an important work presentation, and there was no way she could miss it. She requested her mom to have lunch without her on similar days ahead, which would help Udita meet her needs for support and understanding. She also promised to reheat and serve lunch for herself on such days without requiring her mom’s assistance in the kitchen. Udita also addressed her mom’s needs for connection, certainty, and order and assured her that she would inform her about her everyday schedule when she worked from home, so they could try to have lunch together whenever possible.

Based on Marshall B Rosenberg’s Compassionate Communication Model, Self-Connection, Empathic Listening, and Honest Self-Expression are three modes through which we can apply an impact-focused mindset. None of these modes or processes are a precedent to each other. In any given situation, not necessarily difficult ones, we can resort to either or all of these three modes to understand ourselves and others better beyond the playfield of who’s right and who’s wrong. An impact-focused mindset is about overcoming the rigidness of being the correct/better one, being curious about each other’s feelings and needs, and building concrete strategies together to meet those needs on any given day.

The author is the Linchpin at My Emotions Matter, an education initiative that helps individuals and teams learn the mindset and skills of Emotional Intelligence. You can learn more at myemotionsmatter.com

On paper, the Nepali Congress is in the pink. The party is a key piece in the coalition government in Kathmandu, leading vital ministerial portfolios, such as finance, defense, health and industry. It is also heading three of the seven provincial governments and 295 out of 753 local governments. 

But there is a sense of unease among many leaders and cadres concerning the party’s future. They say the Congress is confronting multiple challenges which if left unremedied could risk the very existence of the party. This sense of anxiety is also widespread among the district-level leadership of the party, which they made clear when they met at the NC headquarters in Sanepa, Lalitpur, last week. 

A word of assurance from NC President Sher Bahadur Deuba would calm the nerves of the party rank and file at this moment, but that has not happened—and is unlikely to happen. The alarm bell ringers in the party represent the rival factions, and Deuba has so far managed to shrug off their grievances. 

Right after the general elections held in November last year, party leaders have been calling for a Central Working Committee (CWC) meeting to discuss the intra-party and national issues, but Deuba has been postponing it. 

The meeting of the party’s executive committee has finally been set up for Wednesday, which is likely to witness a verbal war between the rival factions. For a long time, Deuba had been avoiding the CWC meeting in an apparent bid to avoid criticism and confrontation. The rival factions are prepared for a showdown with the establishment faction. 

There are multiple issues related to the party and the government that the CWC will have to delve into. The first is holding the party's policy convention which should have taken place immediately after the party's general convention held in 2021. The objective of the policy convention is to review and rework the party's ideological standing in the changing context. 

The second issue is about managing the party's sister organizations torn asunder by the intra-party infighting.  

Madhu Acharya, a CWC member, says they are presenting a detailed report on party reformation prepared on the basis of consultations held in all seven provinces and diaspora community. 

“Our first priority is to fix the date and venue of the policy convention and Mahasamiti meeting. If party leadership does not heed to our request, we will launch a signature campaign to hold the party's special general convention to change the leadership,” Acharya says.

It is no secret that the rival factions do not see Deuba’s leadership in a favorable light. Part of the resentment comes from the fact that Deuba holds a significant sway in all party committees, including the CWC and the Parliamentary Party, and almost no decision can be made without his say-so.  

For example, several appointments are pending in the party's sister organizations due to Deuba’s reluctance. Factional feud inside the NC has spread to the local level, and is eating away at the party and its organizations. There are at least four clear factions in the party: the establishment camp led by Deuba, and others spearheaded by Gagan Kumar Thapa, Shekhar Koirala, and Gururaj Ghimire.

Last week’s meeting of district-level presidents of the party was convened by the Thapa camp. Likewise, the Ghimire-led group also recently sent its representatives to all seven provinces for the “NC resurgence campaign”. The Deuba fold is not pleased with the latest activities of the rival groups.   

“It is inappropriate to call a meeting of district presidents when the whole party mechanisms are unaware about it,” says Nain Singh Mahar, a CWC member and a leader close to Deuba, of the district-level leadership meeting organized by the Thapa camp in Sanepa.

Observers say the growing factional rift in the NC will not help the party’s future. While the party may have the largest share of seats in parliament, they say the strength of the Congress party is waning away. Today’s NC cannot fight elections on its own. In the last year’s general elections, the party had to forge an electoral alliance with the CPN (Maoist Center) and other fringe left parties.  

Despite emerging as the largest party, the NC is currently playing second fiddle to the third-place Maoist party as part of a pre-election power-sharing deal. There is a general dissatisfaction inside the Congress over the performance of the current government. Some leaders are of the view that the party will fail to secure its political base if this government fails to deliver. 

Revelation of corruption scandals involving senior party leaders are also not helping the NC. While the government led by Prime Minister Pushpa Kamal Dahal has won acclaim for prosecuting “high profile” individuals, there is a fear that the Maoists could weaponize these corruption cases to ultimately disrepute and weaken the Congress party.   

Many NC leaders are not in favor of joining forces with ideologically opposite communist parties just for the sake of securing parliamentary seats. 

The meteoric rise of the newly formed Rastriya Swatantra Party has also rattled the Congress, along with other traditional mainstream political forces of Nepal. 

The NC youth leaders and members in particular seem tired of Deuba’s leadership.  

A few days ago, NC rival leader and general secretary, Thapa, made his intention known about his plan to unseat Deuba as the parliamentary party leader. 

“I am pretty clear that the same leader should not become prime minister again. So I am trying my best to change the parliamentary party leader,” he said at a public program.

Thapa had contested and lost against Deuba in the PP election held after last year’s general elections. He was defeated by a huge margin despite getting the support from Koirala, another rival leader in the NC.  

Thapa and Koirala are no longer together, as both of them are vying for the post of Congress president. Koirala has been working hard to improve his ties with Deuba.  

In Wednesday’s CWC meeting, Koriala is expected to restrain himself from criticizing Deuba’s leadership. But the same cannot be said for rival leaders Thapa and Ghimire, who could launch an all-out attack on Deuba.