Nursing Now

March 1, 2018, Often in the background, nurses are the heart of every national health system. They do everything from caring for patients to giving lifesaving treatments in emergency; from supervising health workers to ensuring the correct information is passed between doctors and patients. In effect, nurses are the silent heroes.

This week, a new global nursing campaign, “Nursing Now”, is kicking off to both celebrate the critical role nurses play in delivering health services across the world and to ensure that recognition for nurses translates into leadership positions at all levels of the health decision-making system. Nursing Now will run to the end of 2020, which is when nurses will be celebrated worldwide to commemorate the 200th anniversary of Florence Nightingale’s birth.

Nursing Now is an evidence based-campaign. It was conceptualized following a global review of Nursing by UK’s All-Party Parliamentary Group on Global Health, which concluded simply by reiterating that Universal Health Coverage—the central pillar of the health-related Sustainable Development Goal 3—cannot be achieved without developing nursing, globally.

It is no secret that the world’s health system is struggling to cope with old and new problems. Infectious killers like HIV, TB and malaria, are still a major challenge in low- and middle-income countries and growing antibiotic resistance and the risk of a pandemic are presenting a tranche of new challenges threatening progress made in the last decades.

At the same time, largely driven by the global epidemic of obesity and other lifestyle-related risks, every country in the world has seen a rise in noncommunicable disease. Cancer, diabetes, lung and heart disease are now the leading killers of people. This is presenting new challenges along with climate change, new patterns of migration and the risk of new disease pandemics. Reform of national health systems is needed to address the changing global burden of disease.   

One of the basics for delivering quality health services for all is a solid workforce of well trained and supported community health workers, nurses and doctors. To ensure the health workforce can tackle the new health challenges of the 21st century, it is estimated that nine million more nurses and midwives are needed by 2030. In Pakistan, there is a critical need to address this gap, where the current doctor-nurse ratio has been 2.5:1 for some time as opposed to the recommended 1:4.

It is not just the gap in essential nurses that needs to be filled. Too often nurses are undervalued and therefore not able to fulfill their potential. There are a variety of reasons for this, not least the fact that as a mainly female profession, nurses are disadvantaged by traditional patriarchal structures. Despite their holistic understanding of the health system, too often nurses are shut out of the health decision-making system because of strict hierarchies and engrained ideas about the role of nurses.

Going forward, investing in nurses in Pakistan and around the world will improve nurses’ potential and working conditions. Training and leadership skills can deliver a triple impact of improving health, empowering women and strengthening local economies. As a trusted part of their communities, nurses are a key element of how we can overcome today’s health challenges.

If they are properly deployed, valued and included in health decision-making, nurses have a critical role to play in promoting good health, identifying and preventing disease outbreaks, as well as providing care at the community level. When nurses are trained well and given greater scope to expand their roles, they deliver impressive results for patients. Maximising this potential will be vital to achieve the UN agreed global goal for Universal Health Coverage.

We are personally committed to ensuring that we don’t just recognise nurses but that we develop pathways for growth and ensure that we break the patriarchal and hierarchal systems so that nurses are a key element of the health decision making system at all levels. One of us, as co-chair of UK’s All-Party Parliamentary Group on Global Health is leading the global drive to mainstream the role of nursing in health systems. The other author of the Oped, as co-chair of the WHO’s Independent Global High-Level Commission on Noncommunicable Diseases, supported that a nurse was included in the commission. Nurses are on the frontlines of the battle to tackle NCDs and drawing on their skills and experience is critical for how the commission will develop and action new policy recommendations to turn the tide against the leading killers.

For too long nurses have been on the periphery of the decision-making system and as the world’s health changes, we must ensure that nurses are leading the charge in how we restructure health systems to tackle the health challenges of the 21st century.

Lord Nigel Crisp co-chairs UK’s All-Party Parliamentary Group on Global Health. Dr. Sania Nishtar is the co-chair of a High-Level Global Commission on NCDs.


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