As countries roll out COVID-19 vaccination, what are the lessons...
When the 72nd World Health Assembly, in May 2019, designated 2020 as the International Year of the Nurse and the Midwife (YONM), no one foresaw that it would coincide with a global pandemic.
The purpose of YONM was to celebrate the contributions of nurses and midwives to the health and wellbeing of populations, expand evidence of their impact on health outcomes, and stimulate action and investment for a health workforce leaves no one behind on the path to universal health coverage (UHC).
The COVID-19 pandemic has made it incredibly timely to recognize nurses and midwives and their crucial contributions to health systems that protect everyone.
Celebrating, and remembering, nurses and midwives
Celebrations began on 1 January 2020, with contributions from nurses and midwives around the world. As the pandemic emerged and spread, attention in many countries turned to the strain on health services.
Countless stories have shown the bravery and compassion of nurses and midwifes in serving their communities, while at the same time facing uncertainties, challenges and the risk of getting infected. Around the world, the crisis prompted public displays of thanks and recognition for front line health workers.
Tragically, the pandemic has also put nurses, midwives and other health professionals at extra risk. Opening an event organized on the eve of the UHC Day, “Midwives and nurses on the way to universal health coverage: the critical role of women to guarantee access to services during COVID-19 times”, Dr. Tedros commemorated Ms Vjollca Berisha who had served as a nurse at the same hospital for 45 years, was infected with COVID-19, and sadly lost her life only a few days before retiring. As of October 2020, over 1500 nurses were known to have died after contracting COVID-19; the true figure is likely to be much higher.
Recognising and celebrating the contributions of nurses and midwives is not enough. As an essential step towards health systems that protect everyone, the workplace must be safe for health and care workers.
Strengthening the global evidence base on nursing and midwifery
On World Health Day, 7 April 2020, the World Health Organization published the first ever State of the World’s Nursing report. It includes data from over 190 countries and revealed clear findings about the nursing workforce and UHC.
The report highlights the global shortage of 6 million nurses, with 89% of the shortage in low and lower-middle income countries. The international migration of nurses is increasing— approximately one in eight nurses now work in a country other than where they were born or educated. Unless carefully managed (in line with WHO’s Global Code of Practice on the International Recruitment of Health Personnel), migration can contribute further to health worker shortages in sending countries.
This evidence is important to support countries to make the maximum use of their current health workforce—and forecast needs for a health workforce that can meet future health challenges. Without significant investments in nursing education, employment, working conditions, and leadership, global inequities will persist. Development of the third State of the World’s Midwifery report is currently underway and will provide critical information for ensuring a workforce who can deliver sexual, reproductive, maternal, neonatal, and adolescent health services
Stimulating action and investment
Even in the face of the pandemic, the YONM has helped stimulate policy action at global, regional, and national levels.
In June, government chief nursing and midwifery officers and the heads of national nursing and midwifery associations from over 130 countries met to prioritize areas for policy action. Members States of the Eastern Mediterranean Region adopted a seven-point “call to action” to strengthen the nursing workforce for UHC. Chief nursing and midwifery officers of the Western Pacific convened with key stakeholders to articulate their recommendations for regional investments.
At the national level, Chile appointed a Chief Midwifery Officer for the first time and Uruguay created a National Nursing Commission to hold a series of intersectoral policy dialogues about investing in nursing education, jobs, leadership and practice to strengthen primary health care for UHC.
The 73rd World Health Assembly instructed WHO to develop the next iteration (2021-2025) of the Global strategic directions for strengthening nursing and midwifery. This will provide WHO Member States with prioritized policy approaches and tools to strengthen the education of nurses and midwives, increase the number of sustainably funded jobs, ensure nurses and midwives can work to the top of their scope of practice, and support their leadership and input into health policy decision-making.
Newly released guidance from WHO on health workers and COVID-19 outlines how to design, manage and preserve the health workforce to manage the pandemic, maintain essential health services, and respond to new service delivery demands.
YONM has highlighted the need for long-term sustainable investments in the education, employment, working conditions, and leadership of nurses and midwives. Evidence-based investments can create qualified employment opportunities, particularly for women and youth, and can help address the equity and coverage gaps that exist in many health systems. More broadly, the Global strategy for human resources for health: Workforce 2030 provides guidance to countries on inclusive processes to leverage investments in the health workforce to accelerate progress towards UHC and the Sustainable Development Goals.
Looking ahead to 2021
YONM has been especially timely in the context of COVID-19. It has helped engender a deep appreciation of nurses and midwives fighting on the frontlines for both UHC and global health security. Member States at the 73rd World Health Assembly, recognizing the dedication and sacrifice of the millions of health and care workers at the forefront of the Covid-19 pandemic, unanimously designated 2021 as the International Year of Health and Care Workers. This will provide crucial opportunities to build on the YONM and recognise the contributions of all health workers towards shared UHC and health security goals, and health systems that protect us all.
This blog from the Global Health Workforce Network is part of a curated blog series from the UHC2030 Health Systems Related Initiatives. The UHC2030 Related Initiatives promote collective action for stronger health systems that protect everyone. Find out more.
Photo © WHO / Noor - Benedicte Kurzen