A policy of this magnitude requires gradual establishment. The upgrading of the nursing education to degree level, continuous professional development, mentoring and role modeling of expert nurses should be established to prepare local nurses for the localization of the nursing workforce.

Spirituality is multidimensional and multilevel and is interconnected with religiosity and personal belief. Nurses need to understand their own spirituality before they can incorporate spirituality in their patient care.

Five hundred mothers of children under five years participated in a survey to gain perceptions of a community pram walking program designed to promote mental health. Telephone survey (n=450) and focus group (n=50) methods were used. Ninety-two percent of telephone survey respondents (n=416) believed that physical activity could increase mental well-being and 87% (n=390) felt that it could reduce the effects of postnatal depression [PND]. Interestingly, approximately 50% (n=25) of focus group participants felt that mothers experiencing PND would not want to join an exercise group set up for promoting mental well-being and 80% (n=40) stated that marketing messages should not mention mental health in order to avoid labelling or stigmatization. This study has revealed positive attitudes toward the potential of physical activity to improve mental health. However, for promotional purposes, terms such as well-being or reduced stress may be less stigmatizing than mental health.