Nurses, midwives and other frontline health workers are the backbone of the COVID-19 response. Across the WHO South-East Asia Region, nurses and midwives continue to deliver a range of services critical to protecting health and keeping people safe, from providing high-quality, respectful treatment and care to leading community dialogue to address fears and, in some instances, collecting data for clinical studies. Nurses and midwives continue to pull out all stops to ensure that essential health services such as routine immunization and services related to sexual and reproductive health can function amid the pandemic. As we celebrate the International Year of the Nurse and the Midwife, and mark International Nurses Day – which comes a week after the International Day of the Midwife – we must continue to strengthen Region-wide support to nurses, midwives and other frontline health workers so that they can carry out their work efficiently, and also safely.
The WHO South-East Asia Region has in recent years accelerated efforts to strengthen the nursing and midwifery workforce. In 2015 Member States embarked on a Decade for Health Workforce Strengthening, through which the Region increased the average density of nurses and midwives to 18 per 10 000 population by 2018, up from 16 per 10 000 in 2014. As part of the initiative, Member States are committed to ensuring that the work environment for nurses, midwives and other health workers is safe, healthy and satisfying – a critical need that WHO’s first ever State of the World’s Nursing Report, which was released on this year’s World Health Day, emphasizes. Member States must continue to develop and implement legal protections that regulate the working hours and conditions, wages and social protections afforded to nurses and midwives, and which safeguard them from violence.
As the COVID-19 pandemic unfolds, it is imperative that all countries in the Region scale up investments in the health workforce, especially nurses and midwives, who account for around 59% of all health workers. Over the mid- to long-term, Member States should focus on increasing the numbers and skills of nurses and midwives so that by 2030 the Region has as many as 1.9 million more nurses and midwives. But as an immediate priority, policy-makers, health leaders and facility administrators must secure the occupational health and well-being of nurses, midwives and other frontline responders, with a focus on several key areas.
First, all nurses, midwives and frontline responders must be provided the personal protective equipment (PPE) required to reduce the risk of infection from COVID-19 and other pathogens. Across the world, health workers have accounted for a significant proportion of COVID-19 cases, due in part to inadequate access to gowns, gloves, medical masks and eye protection, which is in turn fuelling health worker anxieties. Since the beginning of the outbreak, WHO has provided all countries in the Region PPE, and will continue to support country needs by working with industry, governments and the Pandemic Supply Chain Network globally. In addition to providing adequate PPE, facility administrators should fully implement infection prevention and control strategies and ensure all nurses and midwives have the training and resources to adhere to them.
Second, the psychosocial needs of nurses, midwives and other frontline responders must be supported. To prevent burnout, minimize stress and enhance mental well-being, administrators should appropriately balance working hours, rotate workers from higher-stress to lower-stress functions, and ensure financial resources are available to call up additional staff and pay overtime and sick leave. They should provide staff actionable information on where and how to access mental health and psychosocial support services, while also encouraging key coping strategies such as avoiding tobacco and alcohol and eating sufficient and healthy food. Should the mental health of nurses, midwives and other responders decline, so too will the quality of the services they provide.
Third, leaders at all levels and across sectors must do all they can to protect nurses, midwives and other health workers from stigma and violence. Between 8% and 38% of health workers globally suffer work-related violence at some point in their career. Many more are exposed to verbal aggression and social stigma. WHO continues to call on governments, employers and professional organizations across the Region to take a zero-tolerance approach to violence against health workers, whether at the workplace, on their way to and from the workplace, or at their residence. It is incumbent on each of us to support health workers and their families both in their day-to-day work and as they tackle this once-in-a-generation challenge.
WHO stands committed to supporting Member States in the Region as together we strengthen the nursing and midwifery workforce and promote safe, healthy and satisfying work environments. Nurses and midwives will continue to be the backbone of the COVID-19 response, just as they will continue to be at the fore of the Region’s quest to achieve universal health coverage. On International Nurses Day, which follows on from the International Day of the Midwife, let us be grateful for the remarkable work that nurses and midwives perform day-in, day-out to protect and promote the health of individuals, communities and countries across the South-East Asia Region. Let us do all we can to protect and care for those who protect and care for us.