Empowering Nurses and Midwives to Improve Global Health

In low-income countries, nurses and midwives often serve as the only frontline health care providers. In a remote African province, for example, a sole nurse or midwife might deliver babies, care for patients involved in car accidents, educate people about HIV, and treat complications from diabetes and hypertension.

In spite of their contributions, nurses and midwives do not often have a place as key stakeholders at the health policy table.

To address this issue, global health experts convened at the World Health Organization’s headquarters in Geneva this January to finalize strategic guidelines to strengthen the nursing and midwifery workforce worldwide for the next five years. The Strategic Directions for Nursing and Midwifery 2016-2020 are designed to be implemented by ministers of health, NGOs, and educational institutions worldwide.

Jennifer Dohrn, DNP, director of the Office of Global Initiatives, has been working on these guidelines for the last two years as part of a working group of global health experts.

The guidelines underscore a resolution by the United Nations --- the WHO’s governing body-- that governments move towards providing universal health coverage for every citizen.  However, a shortage of health providers is a major obstacle preventing access to care from becoming a global reality in many countries. To address this challenge, Columbia Nursing serves as a WHO Collaborating Center for Advanced Practice Nursing.

“This is a critical time to develop a vision and plan for our profession to offer high quality, affordable and accessible care,” said Dohrn. “Global health disparities and inequities are increasing. We’re facing complex humanitarian situations, such as the displacement and migration of Syrian refugees. Nursing and midwifery could provide many solutions to these problems.”

To address these problems, the WHO recommendations are categorized into four thematic areas:

• Ensuring an educated, competent nursing and midwifery workforce in different settings.
• Developing policies to improve health outcomes and cost effectiveness of health services.
• Developing partnerships with other healthcare providers and institutions to maximize nurses and midwives capacities to provide quality primary care.
• Encouraging investment in developing the midwifery and nursing workforce.

One recommendation, for example, calls for evaluating nursing and midwifery education programs to ensure they are evidence-based and focus on core competencies.

The WHO plans to publish the recommendations this spring at the World Health Assembly, a meeting where delegates from WHO member states set health policies.

Dohrn feels optimistic that the Strategic Directions will help improve global health outcomes:

“We have evidence if nurses and midwives are empowered with greater capacities and scopes of practice, we will make an impact on the health of the most vulnerable populations,” said Dohrn.

Dohrn points to an example of a nurse-initiated program in sub-Saharan Africa which expanded access to HIV care and treatment in several countries.

Said Dohrn:

“I feel optimistic that the strategies we came up with will provide a clear roadmap to empowering nurses and midwives.”