Regional Strategy for Nursing and Midwifery in the Eastern Mediterranean Region

Transcription

1 Regional Strategy for Nursing and Midwifery in the Eastern Mediterranean Region -

2 Introduction Nurses and midwives increasingly face rising levels of complexity in health care, coupled with expanding scopes of practice and responsibility, some in countries undergoing stunning social and political changes, and others riven by poverty, war civil and political unrest. This requires more educated nurses and midwives with expanded skill sets capable of responding to change, greater demands and new priorities in health care and the social realities in the places they live. The Eastern Mediterranean Region (EMR) of World Health Organization (WHO) developed its first Regional nursing and midwifery strategy in,,- and was adopted by the Regional.ommi/ee in,,0. For over a decade, this framework for action has served as a useful guide to Member States (MS) and the Regional Office in the development of nursing and midwifery workforce and role changes. The Regional strategy has provided strategic directions for policy makers and nursing leaders at the na2onal level. 3n the World Health Organization and its key partners released the strategic directions for nursing and midwifery for the next five years (-4). The Regional.ommittee in its Fifty-Fifth Session in October 0 issued a resolu2on (EM5R.445R4) on promoting nursing and midwifery development in the Eastern Mediterranean Region. 3n that resolution, Member States called for development of a new comprehensive Regional strategy for nursing and midwifery to support Member States in their efforts to scale up nursing and midwifery capacity, creating positive practice environments, developing strong committed leadership and advocating for new specialized roles especially family health nursing within the context of primary health care and advanced practice nursing. Given the evolution of nursing and midwifery in the region, the growth in health systems and the dynamic nature of the heath care environment, coupled with the Regional.ommittee s resolution it was pertinent for the Regional Advisory Panel on Nursing and Midwifery (RAP) to re-visit the regional nursing and midwifery strategy. The Global Situation Overview The World Health Organization and other 3nternational agencies have been warning that future demographics and the profile of disease require significant change in how we organise services, deliver care, and educate our health care providers. Future healthcare models will

3 need to take account of health provider shortages yet meet demands for more individualized care. Ageing; the impact of urbanisation and climate change; high prevalence of mental health problems which will be the leading cause of ill-health by the year ; and the rising tide of chronic non-communicable diseases such as cancer, diabetes and cardio-vascular diseases, often triggered by unhealthy environments and risky behaviours, : are changing the context and priorities of care. Young and old are developing chronic diseases at a record rate, = while the danger of an accelerated world-wide transmission of known and new communicable diseases and the impact of natural and man-made disasters on health and welfare remain ever present 3 > % $ # 3 %? $ %7 $ % - * Alma-Ata Health for All Declaration, ()* &9).' % ) 9). 0 A : 8 8 B 9). % 3 :

4 Region adopted the Qatar Declaration 9). 9)., $% ; C ( + ()* + % % # &..)A). 8 &8'()* % 3 # % % ; ; ; ; $ % % % : = 1 $ 4 % =

5 We are witnessing an expansion in the set of competencies seen as desirable in health. $ $ #?() % ()*? % & ' B6 &B6'8 % D% ; %;7 %; % ; # - *$ #-Islamabad Declaration on Strengthening Nursing and Midwifery % % 3 D ; % %; % #0Chiang Mai Declaration Nursing and Midwifery for Primary Health Care 4

6 set out in The Islamabad Declaration stressing that the requirements for successful mobilization of nurses and midwives includes: Their inclusion as critical policy-leaders in decision-making; Recognition of the full scope of practice of nurses and midwives in community-based care; A strengthening of educational institutions, faculty, the curriculum and research capacity; The establishment of adequate financial and non-financial incentives; and Safe and well-equipped working environments. After two years of monitoring and evaluating the outcomes of key results areas (KRAs) for the strategic directions for nursing and midwifery services set by the World Health * E8 # # %; %; ; % # E8 4 $ &&A 4E8'?

7 Tabl #$#% &#' The Regional Situation The Eastern Mediterranean Region(EMR) ()* ?, : % 8 %F 8 B6 > + 2 G = 3> B > -

8 terms of deaths from traffic accidents 2#)3H B6# % # 4 ) % ># =0 2 --:0 5 2? # 3-3> % $ 0 8= 8 % > % &)' % %, F &?'= ) % # % % $ % 0

9 Health worker migration is an important factor in this region. The wealthier countries, especially in the Gulf area depend greatly on non-national workers to staff their health services. They act as a source of attraction for health workers from countries within and. : 1 6.., I &. 9J 'A / &6..' * A.$ $,

10 Situation of Nursing and Midwifery in EMR #,,= # 5 ) 6 & ' A 9 % 6 *. &K * L8' 3 ) 9. F 5 3.DA 3 K 8 L8 < # D* A 4 1 % &6..' 8 * Nursing Units, National Nursing Strategic Plans Nursing Education &6..' & 'D B 3 Regulation K 9 % * *F L8 < 8 ) A 3 3 E 8 Management & leadership Quality of care and practice * +, # # > D

11 Establishing and reforming basic nursing education and developing post-basic specialty programmes. Strengthening nursing structures in ministries of health Nursing leadership development. Establishing national strategic plans for nursing and midwifery development. Strengthening nursing and midwifery regulation. Nursing research. : 3 # : 2 % > Country Nursing unit in the Ministry of Health Some Regulation In force Professional Regulatory Council Exists National strategy Secondary school completion for entry into practice Nursing education reform Leadership development programmes 8 A B> $ K E F F 8 K * X 9 % * 9 M 8 N 8 N # L8 <

12 3 40*0) ) 1(4( ). A 5 Current Challenges Nursing and midwifery workforce 8 % > : 6 JD 8 > =2% #&3 $ K <' =G%3 $2-G 6, $ 6 A * 3 $ ) 9 %8 F ) =$ 1 >% * % %

13 &:' I % *% ) % 1 1 C 3?% =%J 2%= %*=I2J # 3 &5'9% > % $ % %# D % % :

14 nurses, falling care standards, job dissatisfaction, burn out, and high rates of turnover and attrition. # 2 0 Eastern Mediterranean Regional Committee resolution bilateral agreements and ethical codes of conduct to manage the migration of nurses and midwives and to promote cooperation between countries in the production and recruitment of nurses and midwives :: # $ # &,4' &4 :'2 % # % ; %; ; :=:4 :? :- 6 % % % > % % % % % % :0 Scaling up Nursing and Midwifery Capacity 02 # % =

15 Scaling up education is a necessity if any impact is to be made on the supply side. 3 ; ; $ ; ; C ; :, ( 7 $ 8 % % $ #Islamabad Declaration % % > $$ % $ == ) $ + % % %# %@ = 4

16 practiced at the advanced level in their country, the description of what these actually constituted indicates that there is a very varied understanding of what advanced practice for nurses entails. For some it meant nurses working in a specialist or supervisory roles or carrying one or two advanced tasks, some of which are seen advanced in some countries but as part of the general nurse s repertoire of skills in others. 3 %% = # % % should not be considered as the fundamental distinguishing feature separating advanced nursing practice from generalist nursing. Advanced level tasks are components of the full scope but do not define the essence of advanced practice. *+ ) + % Improving Safety and Quality through Regulation # $ + A # $ #@ 7 nurses and nursing governed by nurses in the public interest %?

17 management of nursing and other health services. This has been considerably assisted by the emphasis of role of properly developed systems of regulation in improving the quality of nursing and midwifery care in the EM regional nursing and midwifery strategy. 3 & ' == ( ) $. $ $ ( % $ %,,0 # ()* % $, =4 $ The Way Forward 3 :()* 8 % =? 8 $ # % # D 3 $ % F -

18 Slowness in implementing educational reform and absent or weak linkages between education and the service sector. 3$ % 1 % % 9 % #. %. F 5 # ) $ D# D 3 % %. 3 $ 8 0

19 Strengthen regulatory capacity and extending professional control. & A' 7-# #-## F (% 9 8 $ 8 8/ 97$##,

20 Vision Nursing and midwifery professionals working as independent practitioners or within multidisciplinary or interdisciplinary health teams will contribute to improved health outcomes for individuals, families and communities through the provision of competent, culturally sensitive, evidence-based nursing and midwifery services. They are active in policy formulation, decision-making and planning at all health system levels. Guiding Principles Ethical: equitable health services, responsive to health needs of all people, especially the vulnerable groups, gender-sensitive and respects human rights. Relevant: health services and nursing and midwifery human resources development, management and deployment systems guided by health needs, evidence and best practice. Ownership: reflects the political, economic and cultural realities in the region, and its health policies and strategic priorities. Responsive: takes account of nurses and midwives needs, expectations and professional aspirations. Partnership: enhances collaborative and supportive efforts with a wide involvement of national, regional and international stakeholders.

21 References World Health Organization, Strategic Directions for Strengthening Nursing and Midwifery Services # #% 6 () * + 2 ()*5))5)95 () * ()*D 6, : () * +. - *: + ()* 8D6 4 = 9.) < --=9. 4 () * ( 8D6 0? 9.) 3 0=? ( )06 (=.9D 0 () * + 2&0' 0=- = --:, () * + > B ( =6 D3. () * + 2&0' 0=- =4- () * $+$ - 8* 9 2=()* 3 = : 8 0=- 44 = 3*&3'6 1 -* ( B.D# =- :? () * + )0? 8 6? - A K. F 4) * * 3. 6 = 0 A K 9 %# %K. +0 =.5() * () * :

22 , Islamabad Declaration on Strengthening Nursing and Midwifery. =? % ) 9 % () * () * Chiang Mai Declaration Nursing and Midwifery for Primary Health 0848 D5555O5 O O () * + A Global Survey Monitoring, Progress in Nursing and Midwifery &()*5))5)95=' 8 6 () * + &' Op. Cit. : () * + The Work of WHO in the Eastern ) ##*)0) *. = == ? () * ( ) = *. 0 - : 0 E 6 B 8%F) 8 Nurse Specialty Certification, Inpatient 0 ;=:D 00C,=, () * + ) +) ( ) &#$##' *. &' : : () * + &0' 0=- =: : #13 ). #. )++ =8:8 /D5553#53#OOJ5J O 2 :: ( ) := P9 B. A DB (% :4 99 ) ( D %551 99) 9

23 :? Positive Practice Environments for Health Professionals, Fact Sheet: Incentive Systems for Health Care Professionals. Accessed 8 D %551 3 :- F % H8 Magnet Environments for Professional Nursing Practice 3)6 &' 9 M D8A ) % %&B'D8 ) M &L' 0 :0 *7A9 F8 Nursing Workforce Planning: Mapping the Policy Trail :, 8 Op. Cit. = () * + Task Shifting: Global Recommendations and Guidelines = Joint Health Professions Statement on Task Shifting 88 /D55 5 OO = 3. B2. 288: D55 %5 =: 8I A %? :4 == World Health Organisation, Regional Office for the Eastern Mediterranean. Op. Cit. 1997, p 13. =4 () * + Global Standards for the Initial Education of Professional Nurses and Midwives.8 6, =? () * + 8 Nursing and Midwifery Workforce Management: Analysis of Country Assessment 8*# 9 2? 8 B : :