Global inequity in nursing education: a call to action

Abstract

The guidance for action identified through this report is essential to navigating the world's health, now more than ever. The COVID-19 pandemic has urged us all to critically assess the ways social determinants of health influence health outcomes and how adverse social determinants exacerbate local, national and global health inequities in our work, in the health outcomes for the patients we treat and their families. More importantly, the ongoing consequences of this pandemic have called for us to see our health systems as part of the larger society in which we live, learn, work and play, and to take informed action and to do something more about the inequalities in our midst. This report is in direct alignment with the values of the World Health Organization (WHO)-collaboration, caring for all people, integrity in practice, service to public health, and excellence throughout the health sector. The WHO's 2020 State of the World's Nursing report recommended continued investment in jobs, education and leadership opportunities for nurses and the support of inter-sectoral partners worldwide. We need to continue to translate these ideals into practice. The six domains for action articulated in this report begin to pave that path.We have much work to do if Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) are to be achieved by 2030. With roughly 1.2 billion people living in extreme poverty, over 842 million suffering from hunger, and insufficient access to quality health and education services for many of the world's populations, there needs to be a global commitment from the health sector to assume a stronger role in social development by addressing the social determinants of health where there is a role to do so. Several of these roles for nurses are crystallised in this report: nurses understanding the context of people where they are, and bridges to contextualising health and social care services in deliberate ways.The global status and profile of nurses have improved considerably with the support of international campaigns, such as Nursing Now, and the commitment of the WHO in designating 2020 as the Year of the Nurse and the Midwife. However, we will need strategic partnerships with all governments and policy makers to ensure we optimise and leverage the nursing workforce to achieve UHC and the SDGs. I encourage all governments, ministries of health, chief nursing officers and organisational bodies at local and international levels to advocate for investments in nurses and nursing to achieve our shared vision of health for all-leaving no one behind.An estimated 28 million nurses account for nearly 60% of the professional global healthcare workforce. Nurses are essential for creating, planning, delivering and evaluating healthcare services. We must continue to invite them to all decision-making tables to honour their voices and integrate their vision. We must mature the nursing role to value them as the advocates, leaders, scientists, educators, researchers and clinicians they are traine...

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“…8 Increasing the number of competent nurses is critical to achieving a competent global nursing workforce. 8,9 Nurses need advanced clinical and critical thinking skills to manage complex care situations. 8 Enhanced education gives nurses increased confidence in not just practical skills but also interpersonal and management skills.…”

“…2 A challenge for many regions is that they do not have adequate numbers of professional nurses or the resources to educate them to the fullest extent. 8,9 Nurse-topopulation density varies across the world, with the greatest gaps in African, South-East Asian, and Latin American countries. 7 Specific nursing initiatives include Project Hope, the Nursing Now Campaign, and the Nightingale Initiative.…”

“…Unfortunately, in many places, education has not kept pace with the constant changes and challenges in healthcare 8. Increasing the number of competent nurses is critical to achieving a competent global nursing workforce 8,9. Nurses need advanced clinical and critical thinking skills to manage complex care situations 8.…”

“…Some of the goals of global nursing are to increase effective nurse-led models of care, optimize the contributions of nursing, and support a positive environment for nursing practice 2. A challenge for many regions is that they do not have adequate numbers of professional nurses or the resources to educate them to the fullest extent 8,9. Nurse-to-population density varies across the world, with the greatest gaps in African, South-East Asian, and Latin American countries 7…”