Nursing And Midwifery In The Eastern Mediterranean Region. Arwa Oweis Regional Adviser For Nursing, Midwifery and Allied Health Personnel

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1 Nursing And Midwifery In The Eastern Mediterranean Region Arwa Oweis Regional Adviser For Nursing, Midwifery and Allied Health Personnel

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3 The WHO Eastern Mediterranean Region Political instability, conflicts and civil unrest are long-standing features of this Region. Population exceeded 600 Million

4 Priorities for HSS in EMR RC59 1. Move towards Universal Health Coverage 2. Reinforce leadership and governance in health 3. Strengthen Health Information Systems 4. Promote a balanced and well managed Health Workforce 5. Improve access to quality Health Care 6. Partner with the private health sector 7. Ensure access to essential technologies Health Financing within the Overall Agenda of Health System Strengthening for UHC in EMR: Challenges and Priorities 4

5 Health in the Sustainable Development Goals 13 Targets 26 Indicators 3.C Substantially increase health financing and the recruitment, development,training and retention of the health workforce in developing countries. Health Financing within the Overall Agenda of Health System Strengthening for UHC in EMR: Challenges and Priorities 5

6 Moving from MDGs. Achievements in MDG targets in EMR (2015)

7 Countries MDG 1 (underweight children under 5) Bahrain Kuwait Oman Qatar Saudi Arabia UAE MDG 4 (under 5 mortality) MDG 5 (MMR more than 75%) Group 1 6 2/3 1/5 2 Egypt Iran Iraq Jordan Lebanon Libya Morocco Palestine Syria Tunisia Group 2 8 5/1 3 4 Afghanistan Djibouti Pakistan Somalia Sudan Yemen Group All Groups 14 8/4 4/5 7 MDG 6 (Malaria)

8 60 Density of Nurses Per 10,000 Population in the Three Groups of Countries 50 Density / 10,000 Population Group 1 Group 2 Group

9 Lebanon Jordan Bahrain Saudi Arabia Sudan Kuwait Oman Palestine Qatar Libya United Arab Emirates Tunisia Iran Syria Egypt Iraq Pakistan Morocco Yemen Afghanistan Djibouti Somalia Density of physicians and nurses & midwives per 10,000 population, 2014 (or latest available year) Physicians Density per 10,000 population

10 Nursing and midwifery in the EMR: the context WHO has historically invested in nursing and midwifery since its establishment One of the first regions to develop: Regional nursing strategy Standards for pre-service nursing education including prototype curricula

11 Summary of Key N&M Challenges and opportunities in EMR

12 Shortage 72% 37% 54% 16of 22 countries have fewer than 15 nurses per 10,000 population 6of the 16 countries have fewer than 10 nurses per 10,000 population Non-nationals in group 1 countries *An estimated 23 health workers per 10,000 population are needed to provide essential health services

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17 Governance: Regulation 40% regularly monitoring and evaluating standards regular evaluation and monitoring none

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20 Workforce: Job satisfaction 47% satisfaction not on the rise due to working conditions not on rise

21 WHO RESPONSE TO CHALLENGES

22 WHO RESPONSE TO CHALLENGES Strategic guidance Framework for action on strengthening nursing and midwifery Regional strategic framework for health workforce development Framework for action on reforming health education Strengthening health workforce information and evidence Health workforce observatories Mapping selected nursing indicators in EMR Primary care health workforce case studies a work in progress towards operationalizing the framework for action Surveys Eastern Mediterranean Region: Situation of Nursing and Midwifery, Situation of Regulation of Nursing, Midwifery and Allied Health in the Eastern Mediterranean Region,

23 WHO RESPONSE TO CHALLENGES Guiding documents A guide to Nursing and Midwifery Education Standards A prototype nursing curricula A guide for the development of nursing specialization Capacity building Leadership Mental health nursing course Fellowships

24 Technical support to MS Governance, regulation and leadership Reviewed the Directorate of Nursing structure, policy and functions at the Ministry of Health, KSA Implemented the leadership for change program in 9 countries Strengthening Nursing Research in Kuwait Developing the National Strategy and Plan of Action for Nursing and Midwifery Development In Iraq , Iraq Quality of Education and Practice Developing key performance indicators (KPI) for nursing, UAE Developed accreditation system of midwifery practice and education, Iran Assessed all aspects of Djibouti's Higher Institute for Health Sciences on various levels Implemented the BSc prototype nursing curricula, Yamen Assisted OMAN MOH to introduce advanced nursing practice roles of nurses working in PHC, Developed guidelines on Nursing and Midwifery specialization, GCC

25 Strategic Directions The Regional Framework for Action in the Eastern Mediterranean Region was presented to the Pre-RC62 October 2015, finalized and presented to the Ministers of Health in May 2016

26 Vision of the Framework Progressing towards the Sustainable Development Goals and the Universal Health Coverage, nurses and midwives, as part of the multidisciplinary healthcare team, contribute to improved health outcomes and the well-being of the society.

27 Domain Strategic Direction Priorities Governance and Regulation SD1: Nurses and midwives will play a major role in the governance of nursing and midwifery services to meet the national health priorities. SD2: Nurses and midwives are regulated through legal bodies/ authorities which are mandated to implement sustainable, and robust regulatory policies and practices. Establish and strengthen the nursing and midwifery department/ directorate at the Ministry of Health and other key health sectors. Establish and strengthen National Nursing and Midwifery regulatory bodies/and regulatory processes.

28 Domain Strategic Direction Priorities Workforce Management Systems SD 3: Human resources planning and management ensure maintaining adequate numbers, distribution and an appropriate skill-mix of nurses and midwives to meet national health priorities. Ensue continuous monitoring of nursing and midwifery workforce with reliable information. Ensure countries have a national nursing and midwifery workforce plan. Increase recruitment capacities. Introduce flexible deployment and retention strategies of nurses and midwives. Practice and Services SD 4: Nurses and midwives practice to the full extent of their education, scopes and standards to ensure Universal Health Coverage and quality health outcomes for all population. Develop quality improvement system/ standards for nursing and midwifery services. Introduce expanded or advanced practice nursing and midwifery roles.

29 Domain Strategic Direction Priorities Access to Quality Education SD 5 Nursing and midwifery education produce adequate numbers of generic and specialized nurses with relevant competencies. to meet the population needs. Invest in strengthening capacities and quality of nursing and midwifery education. Improve/strengthen the quality of nursing/midwifery education programme delivery. Build the capacity of persons involved in nursing and midwifery education planning, management and evaluation. Research Responsive to Health Priorities SD 6: Nurses and midwives are engaged in research that is responsive to health priorities and that informs nursing and midwifery policies and practice. Translate and utilize nursing and midwifery research evidence into nursing practice and education as well as national health priorities

30 Way Forward Strengthening nursing and midwifery within the EMR is one of five WHO strategic priorities. WHO will continue to reinforce nursing and midwifery as a priority in the coming years. Continue the technical cooperation to support Member States in the implementation of the Regional Framework for Action toward achieving the global agenda of (SDGs).

31 Thank you