Training, mentoring, employment: a pathway that changes lives

A healthcare career pathway that strengthens a whole system

When health systems struggle, it’s often because there aren’t enough trained people to provide care — and because many capable young people never get the chance to qualify in the first place.

A newly published research paper in Frontiers in Health Services shares learning from EMMS International’s Healthcare Career Pathways (HCP) programme, delivered in partnership with The Duncan Hospital in Bihar, India. The case study explores how a targeted, supported route into healthcare training can help address workforce shortages while opening doors for young women facing significant social and economic barriers.

Why this matters in Bihar

Bihar is a setting where healthcare workforce shortages and gender inequality intersect in ways that shape both access to care and access to opportunity. In many communities, the costs and constraints around education, mobility, and social expectations can prevent a young woman from pursuing professional training — even when she has the ability and ambition.

HCP was designed to respond to that reality, starting from a simple idea: a pathway is only effective if it’s built around the barriers people actually face.

What is Healthcare Career Pathways (HCP)?

HCP supports young women from economically and socially marginalised backgrounds to enter accredited healthcare training and to transition into stable, local, and sustainable employment.

At Duncan Hospital, the programme combines:

• Targeted selection using a structured approach to identifying vulnerability

• Mentoring and preparation (including practical support such as interview readiness and language skills)

• Financial support that reduces the burden of tuition costs

• Ongoing follow-up and encouragement while students study away from home

• A clear route into work, including guaranteed local employment at Duncan Hospital after graduation

The goal isn’t only to help individuals qualify — it’s to strengthen the workforce in ways that benefit patients, families, and the wider community.

What the research found

By 2025, the programme had supported 54 marginalised young women into accredited healthcare training, and 24 graduates were employed at Duncan Hospital.

The evaluation also highlights wider changes beyond employment. Participants reported increased confidence and independence, and the research notes shifts in community expectations — including delayed marriage and reduced dowry demands linked to women having clearer professional prospects.

At the hospital level, staff described practical benefits too: improved staffing reliability, reduced turnover, and the value of locally rooted healthcare workers who can communicate well with patients and build trust.

What we’re learning

One of the most important insights from the paper is that workforce development isn’t only about recruiting more people — it’s about removing preventable barriers and creating the conditions for people to thrive.

The research also candidly reflects on challenges and lessons for strengthening the model over time, such as:

• ensuring outreach reaches beyond communities closest to the hospital

• supporting mentoring when distance and digital access make follow-up harder

• exploring a broader range of healthcare career routes as the programme grows

These are the kinds of practical learning points that help partners (and the wider sector) improve scalable, sustainable approaches.

A replicable model — rooted in partnership

HCP began in Malawi and was extended to Duncan Hospital in 2019. EMMS is already replicating in other hospitals in India and Nepal. That matters because solutions to workforce shortages need to be more than one-off success stories — they need to be adaptable, locally owned, and sustainable over the long term.

Read the research

If you’d like to explore the findings in more depth, you can read the full paper here.