New Delhi: Delhi’s hospital corridors are speaking in new accents. For decades, nurses from Kerala formed the backbone of the capital’s private healthcare system, valued for their training, discipline and clinical expertise. But hospitals are now witnessing a steady demographic shift, with recruitment expanding rapidly to the Northeast and parts of north India. Nursing administrators say candidates from Manipur, Sikkim and Mizoram are increasingly filling junior and mid-level positions, and states such as Uttar Pradesh, Bihar, Rajasthan and Uttarakhand are beginning to emerge on recruiters’ radar.The transition became sharper after the pandemic. Better pay scales in Kerala, rising overseas opportunities and stronger local demand reduced the outflow of Malayali nurses to Delhi. At the same time, the growth of nursing institutes in Tier-2 and Tier-3 cities widened the talent pool. Hospitals say hiring today is less region-driven and more focused on skills, adaptability and patient care, creating a more diverse and pan-Indian nursing workforce than ever before.According to estimates provided by Deepa Kakkar, chief nursing officer, Asian Institute of Medical Sciences, Kerala nurses accounted for about 50-65% of nursing staff in many Delhi-NCR private hospitals between 2008 and 2012, while north Indian nurses represented around 10-15%. Nurses from eastern India had only a marginal presence during the period.That composition began changing steadily over the next decade. Between 2013 and 2016, the share of Kerala nurses dropped to about 40%, while north Indian representation rose to nearly 25%. By 2017-2020, Kerala’s share had declined further to roughly 25-40%, while north Indian nurses grew to nearly 40% of the workforce.Hospitals say nurses from Kerala were preferred because of their strong educational background and communication skills.The most dramatic shift, according to administrators, has occurred after the pandemic. Since 2021, Kerala nurses are estimated to account for just 10-25% of the nursing workforce in many Delhi-NCR private hospitals, while north Indian recruits now make up nearly 40-50%. Eastern states like West Bengal and Odisha together contribute another 20-30%, according to industry estimates shared by Kakkad.“The Kerala nurses were once preferred because of their strong nursing education, English-speaking background and long migration culture,” Kakkad said. “But hospitals today are finding it much harder to recruit Kerala nurses compared to earlier years, and recruitment has diversified significantly.”She added that UP alone now contributes nearly 20-30% of nursing recruits in several Delhi-NCR private hospitals, followed by Bihar at 10-20%, West Bengal at 10-15% and Odisha at 8-12%. By contrast, Kerala’s share has fallen to nearly 10-20% in many institutions.At Aakash Healthcare, the nursing workforce today reflects what administrators describe as a “pan-India participation”. The hospital has nearly 420 nurses and recruits roughly 100-125 nurses every year to support expansion and operational requirements.“Traditionally, a significant proportion of nursing recruits came from Kerala because of its strong nursing education ecosystem,” Dr Aashish Chaudhry, MD, Aakash Healthcare. “Even today, the southern region contributes a substantial share of our nursing workforce, but over the past few years, we have seen increasing participation from UP, Bihar, Uttarakhand, Rajasthan and the Northeast.”Hospital administrators say the transition accelerated after 2020, when nursing institutes and training infrastructure expanded rapidly in northern and eastern India. Improved mobility and growing healthcare awareness also encouraged more young professionals from smaller towns to enter the sector. Hospitals say their workforce reflects far greater regional diversity now than it did a decade ago, improving multilingual communication and patient engagement.At PSRI Hospital, administrators describe the current workforce as a “layered demographic transition”. Senior nursing administration continues to be dominated by experienced Malayali professionals who joined years ago, while junior and mid-level positions are increasingly being filled by recruits from the Northeast and northern India.“For decades, Kerala was the primary nursery for our nursing workforce and formed the backbone of our clinical care teams,” said Basant Panda, general manager-HR, PSRI. “But today, most junior-level recruitment is coming from Manipur, followed by Sikkim and Mizoram. We are also seeing a growing presence from Rajasthan and Himachal Pradesh.”According to Panda, the decline in recruitment from Kerala became noticeable nearly six to seven years ago and intensified after the pandemic. “Salary revisions in Kerala and increasing international opportunities have made it more viable for nurses to stay closer to home or move abroad, reducing the supply to Delhi-NCR,” he said.Hiring patterns reveal a clear pivot point. Before 2018, recruitment remained heavily concentrated in Kerala and other southern states. During the Covid years between 2019 and 2021, hospitals saw stagnation in Kerala recruitment as local demand in the South increased. From 2022 onwards, recruitment from Manipur and other northeastern states rose sharply to fill staffing gaps.The changing geography of recruitment has reshaped training and retention strategies, say hospitals. With nurses now entering from varied linguistic and educational backgrounds, many institutions have expanded induction programmes and introduced clinical competency bridge courses.“Recruitment today is increasingly competency-driven and less region-specific,” Chaudhry said. “Hospitals are focusing on clinical preparedness, communication skills, adaptability and patient-centric care rather than hiring from any one traditional belt.”
