Nurses And Midwives Are The Largest Group Of Health Workers

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1.1 Introduction
Nurses and midwives are the largest group of health workers who provide a wide range of health services, which include promotive, preventive, curative, rehabilitative and supportive care to individuals, families and groups (World Health Organization 2006). Modern day nursing embraces growing technology, theoretical advancements and increasing accountability (Mason and Whitehead 2003). Their adequate representation and utilization in the health care system is very crucial to achieve the results for the services that are rendered in the community. However given that the nursing practice is profoundly dependent on the health policies and available resources in a country many developing nations fall back
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These observations shall form the base upon which suggestions regarding the rationalization of the professional practice can be made. With the education and training nurses receive it would be highly beneficial for the health system if their expertise is rightly tapped within the system.

1.2 Statement of the Problem
Nurses if optimally utilized in the health care system can have a great impact in the health outcomes of the population as well as on a larger note in bringing down the cost of health care in a system. However nursing remains a largely unexplored area when it comes to its actual utilization in India. The scenario remains largely the same, perhaps marginally better when it comes to the public health care sector in Kerala. There is a dire need to focus more on the comprehensive utilization of the nursing sector in order to ensure health care for all. This study attempts to understand the roles and responsibilities that are assumed by the nurses of different cadre within the public health care system of Kerala. The study will also try to find out the current qualifications and job profiles of various nursing cadre within the system. It is highly imperative to have a clear understanding about the roles assumed by the nurses in order to see how well they can be better utilized in the health care delivery system of the state.

1.3 Rationale and Scope of the Study
The World Development Report of 1993 suggests
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