On World Health Day 2020 WHO calls on all countries to celebrate, support and strengthen the nursing and midwifery workforce. Nurses and midwives are central to the delivery of quality health services for all. They are highly effective in delivering services that prevent illness and promote health throughout the life-course, from caring for mothers, newborns and children to giving life-saving immunizations, health advice, and looking after older people. Nurses across the world continue to respond to COVID-19 with exceptional commitment and resolve. As the world celebrates the International Year of the Nurse and the Midwife, which marks the 200th birth anniversary of Florence Nightingale, we must redouble our efforts to ensure the nursing and midwifery workforce has the strength, skills and support to meet all people’s health needs.
The WHO South-East Asia Region has made important progress. In 2015 the Region embarked on its Decade for Health Workforce Strengthening. All Member States are committed to overcoming shortages and skill-gaps in the nursing and midwifery workforce. By 2018 the Region had increased the density of nurses and midwives to 18 per 10 000 population, up from 16 per 10 000 in 2014. Almost all countries have now met and surpassed the original WHO threshold of 22.8 health workers per 10 000 population. Though the global average density is 37 per 10 000 population, the minimum should be 40. By 2030, the Region will require as many as 1.9 million more nurses and midwives. All countries must sustain and accelerate progress.
As part of World Health Day celebrations, WHO is releasing the first ever State of the World’s Nursing Report. The report provides a comprehensive look at how the nursing workforce will help deliver universal health coverage (UHC) and the Sustainable Development Goals (SDGs). It highlights several areas for policy development in the next three to five years and complements what will be the third State of the World’s Midwifery Report, which WHO, UNFPA and the International Confederation of Midwives will release next year. Both documents are designed to drive investments in the nursing and midwifery workforce to achieve UHC and the SDGs and help deliver gender equity.
One of the most crucial investments countries can make is in nursing and midwifery education. Demographics are shifting. So too are health needs. Across the Region, there is an increasing demand for services for NCDs, care for older people and the terminally ill, and which strengthen health security. For nurses and midwives to respond to these needs, in addition to conventional needs, policymakers and administrators should review pre-service education, including curriculum and faculty development. Where necessary, they should update and amend it. All nurses and midwives should be provided ongoing professional development opportunities, including in-service training, to enhance their knowledge and skills. Tomorrow’s health challenges may be different from today’s.
Policymakers and administrators should ensure that the work environment for nurses and midwives is safe, healthy and satisfying. The hours nurses and midwives work should be reasonable and aligned with national labour laws. The on-the-job hazards nurses and midwives are exposed to should be minimized and, wherever possible, eliminated. Nurses and midwives should never be subjected to violence. By providing a positive and enabling environment for nurses and midwives, policymakers and administrators will increase recruitment, retention and motivation. This is particularly important as countries enhance the quality of health services in remote and hard-to-reach areas.
Increased focus should be put on strengthening nursing and midwifery leadership and management. Evidence shows that countries that have a chief nursing officer and a nursing leadership programme have stronger regulatory environments for nursing and midwifery. This helps them to ensure all nurses and midwives have adequate capacity and skills and can work effectively in interdisciplinary teams. It also means that, when developing policy, health leaders are more likely to benefit from the knowledge and experience nurses and midwives have. Nurses and midwives must be enabled to develop their leadership potential and participate in key decision-making forums.
The WHO South-East Asia Region must accelerate momentum. The Region is now in the sixth year of its Decade for Health Workforce Strengthening. We must pick up the pace and drive further gains. As we celebrate World Health Day, and mark the International Year of the Nurse and the Midwife, WHO reiterates its commitment to supporting all countries in the Region to strengthen their nursing and midwifery workforce. Together we can achieve UHC and SDG 3, and advance the equity agenda. Health for all at all ages is possible. We must make it happen.