The impact of nursing and midwifery around the world

A nurse stands with her arms folded

On the day the Nursing Now campaign is launched, the Chief Nursing Officer at the World Health Organisation and the President of the International Council of Nurses preview their session at the 2018 CNO Summit highlighting the importance of nursing and midwifery globally and its vital impact for people in our care.

At the United Nations General Assembly in September 2015, the nations of the world signed up to the ambitious goal of Universal Health Coverage (UHC).

They committed to the belief that everyone, everywhere, should have the right to receive the quality health services they need without suffering financial hardship. Nurses and midwives constitute the greatest proportion of the global health workforce and have a key role to play in the achievement of UHC.

Around the world, health systems are increasingly stretched. System constraints such as fragmented models of service delivery focused on curative care and based on hospitals and single diseases; a lack of engagement and empowerment of people and communities in looking after their own health; and insufficient and misaligned funding, are taking a toll on frontline care providers who suffer from moral distress every day because they are unable to provide quality, people-centred care to patients.

To address these growing challenges, the World Health Organisation has developed a framework for integrated people-centred health services. The framework serves as a guide for national governments, provider organisations, communities and system leaders to design, organise and deliver care to better meet people’s needs.

The framework acknowledges that for health care to be truly universal, relevant and responsive to the changing world, a critical shift is needed – from health systems designed around single diseases and health institutions towards health systems designed for people, with people.

People-centred health service delivery reforms are critical to addressing 21 century health system challenges, and to achieving UHC. This is highlighted in WHO’s 13th General Programme of Work – a strategy that will guide the Organisation’s work over the next five years from 2019 to 2023. If approved by member states at the upcoming 71st World Health Assembly in May, this document will serve as a north star for the global health community in its efforts towards health for all.

Throughout history, have nurses and midwives have never been so well positioned to take up the call of people-centred care, and to have the knowledge, vision and leadership to steer health systems in that direction. As we well know, people-centred care is not new to nursing and midwifery; in fact, it has always been fundamental to our theoretical and ethical core. Transforming healthcare to meet 21st century health challenges will require nursing, midwifery and care staff to understand the needs, values and preferences of people – and to customise care and respond with meaningful, evidence-informed interventions that result in better health.

Successfully adopting a culture of people-centred care across the entire health system will also require more inclusive ways of decision-making, with a greater focus on patient and caregiver voices and experiences.

It will require shifting from top-heavy, bureaucratic processes to bottom-up initiatives that resonate with frontline care providers and which appeal to their intrinsic motivation to care for people and communities.

There are already many examples of ways in which nurses are reaching more people with health advice and quality care: providing health education to patients and families; outreach programmes to serve the disadvantaged and marginalised; supporting transition across different care settings such as hospitals, primary care, hospices and the home; training of community health workers; building a culture of safety and quality; contributing to e-health technologies such as mobile apps and information systems; and working across sectors to advocate for health in all policies.

Many of these examples can be found in the International Council of Nurses’ resources and evidence for International Nurses Day.  Nurses: A Voice to Lead – Health is a Human Right, will be launched on 27 February, highlighting the work of nurses around the globe to improve access to health care, deliver people-centred care, and ensure Universal Health Coverage for all.

The creation of a positive practice environment is critical, and central to this is the capacity to recruit and retain the nursing workforce.   This is particularly crucial within the context of Brexit and the evidence from the Nursing and Midwifery Council regarding the reduction in overseas applicants.  We must find ways to encourage nurses to come into the profession and work towards retaining them in the profession, otherwise we have no workforce to deliver UHC.  With the shortage in the UK and elsewhere in the world, this is a problem we cannot ignore.

The 21 century people-centred health system must be dynamic, flexible, inclusive and participatory.  Nurses have a critical role to play in sparking dialogue within the health system to embrace approaches that are responsive to the comprehensive needs of people.

As we look ahead, we look forward to working with health leaders to create an enabling environment for people-centred innovations and ideas to flourish, and we both look forward to meeting you all at the CNO Summit in just a few weeks’ time.

  • The 2018 CNO Summit will be held at the Liverpool Arena and Conference Centre on March 7 and 8.
  • The Nursing Now campaign aims to raise the status and profile of nursing. Run in collaboration with International Council of Nurses and the World Health Organisation, the campaign seeks to empower nurses to take their place at the heart of tackling 21st Century health challenges.
Elizabeth Iro

Elizabeth Iro started in her role as Chief Nursing Officer of WHO in January 2018.

She is from the Cook Islands, Mrs Iro has served as the country’s Secretary of Health since 2012. She was the first nurse/midwife and woman to be appointed in this position.

In this role, she has implemented legislative reforms to strengthen the country’s health system and developed the National Health Strategic plans (2012-2016, 2017-2021)and a National Health Road Map 2017-2036, among other National policy and strategic documents.

Prior to this role, she served as the country’s Chief Nursing Officer from 2011 to 2012. In addition, for the first 25 years of her career, she was a practicing nurse and midwife, serving in several roles in the Cook Islands and New Zealand.

Annette Kennedy

Annette Kennedy was elected 28th President of the International Council of Nurses (ICN) in June 2017 after serving four years as Vice President.

Previously, she held the position of President of the European Federation of Nurses and was active in lobbying the European Parliament, Commission and Council.

A Registered Nurse and Midwife with a BA in Nursing Studies and an MSc in Public Sector Analysis, Annette was the Director of Professional Development for the Irish Nurses and Midwives Organisation for 19 years and established the INMO’s very successful Education, Research and Resource Centre.

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One comment

  1. Doris Grinspun, CEO of RNAO says:

    Terrific update and awesome campaign with Nursing Now!

    Does Annette Kennedy have a tweeter account?