At last, nurses get a seat at the table of health decision-making

by Sheila Tlou | Nursing Now
Thursday, 1 March 2018 14:10 GMT

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We need nurses now more than ever, with countries everywhere facing a rising global burden of chronic diseases and ageing populations

Nurses around the world have been coming together this week to celebrate the launching of a new campaign that aims to give them a voice and seat at the table in health decision-making.

Nursing Now launched by its patron, Britain's Duchess of Cambridge in collaboration with the World Health Organization (WHO) and International Council of Nurses at events in London, Geneva, Jordan, South Africa and the United States. 

The campaign represents a turning of the tide for nurses who are too often undervalued and under-utilised by health services. Now they are being celebrated and supported to fulfil their fullest potential as health leaders.

We need nurses now more than ever. Countries everywhere, rich and poor, are facing a rising global burden of chronic diseases and ageing populations, not to mention the impact of emerging factors such as climate change and migration. They are also grappling with an acute shortage of health workers. To reach the Sustainable Development Goals, the WHO estimates we will need nine million more nurses and midwives by 2030 - including 2.8 million more in Africa and 1.9 million in South East Asia.

Why are nurses so vital? As the health professionals closest to the public, they are the lynchpins of effective health teams. They can spearhead essential prevention and health promotion work, which will help the world tackle the rising wave of diet and lifestyle-related conditions.

With health services under severe strain everywhere, there is a growing consensus that we need to move from a 'bio-medical' focus on treating disease to a more people-centred approach, collaborating with the patient to focus on disease prevention and healthy living rather than just dishing out drugs. Nurses are already leading this paradigm shift.

There are examples from all over the world of innovative nurse-led care. The International Council of Nurses’ report, "Nurses, A Voice to Lead", released this week, includes many examples, including one I have witnessed in my region - the role nurses have played in taking HIV testing and counselling out to rural communities and overcoming stigma.

Africa is home to many more innovations. In Rwanda, a network of nurse entrepreneurs is working with the country's health service and insurance scheme to reach 10 per cent of the population.

When I became Minister of Health of Botswana in 2004, with the mandate to roll out anti-retroviral treatment for people living with HIV, there were very few medical doctors.  Nurses were trained in AIDS treatment and care and could prescribe drugs and follow up with patients. This led to Antiretroviral drug access increasing to 80 percent of the eligible population within four years, with very high adherence rates, and mother-to-child transmission of HIV reduced from 28 percent to eight per cent within that same period. All this was possible because nurses were adequately educated, trained, rewarded, and supported to offer such complex care. They are still the backbone of reaching HIV treatment and prevention targets for 2020 and 2030.

Everywhere we hear the same refrain: nurses are the health professionals people know and trust. Who better than to manage a person's health, from the cradle to the grave, in a holistic way, taking into account physical and mental health, as well as socio-economic and lifestyle factors contributing to disease?

For the next three years, Nursing Now aims to raise the profile and status of nursing worldwide. It will advocate for nurses to be included in the leadership of global health bodies and support nurses to navigate policy-making processes so they can have a greater say in decision-making. It will help them to access better leadership education and training and build a global network of nurse leaders to share research, ideas and stories of best practice.

The potential for nurses to do jobs that are more varied and take on more responsibility is still overlooked by doctors and other health colleagues in many parts of the world, sometimes because of strict hierarchies and fixed ideas about what they can and cannot do. If they are genuinely committed to reaching the goal of Universal Health Coverage by 2030, governments must prioritise investments in nursing.

The benefits - for all of us - are clear. Studies in several countries have shown that when nurses are trained and given greater scope to expand their roles, they deliver impressive results for patients. However, beyond this, health leaders must listen to nurses and invest in new models of care if they are to get the most out of this most precious resource.

Sheila Tlou is a former Minister of Health of Botswana; former UNAIDS Regional Director for Eastern and Southern Africa, and co-Chair of the Nursing Now campaign. She is an HIV/AIDS and women’s health expert, and a nurse educator.

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