Challenge of Global Nursing Care and Health Policy

Investigación en Enfermería: Imagen y Desarrollo, vol. 20, núm. 2, 2018

Pontificia Universidad Javeriana

Annette Kennedy

International Council of Nurses, Suiza

Dear Colleagues,

It is no secret that the frenetic pace at which globalization has advanced in the past few decades has brought with it a set of highly critical questions for governments and many challenges for us in our role as nurses and advocates of good quality patient care. We are not averse to challenges, but we need to meet these challenges with information, competence, and skill. We need to participate in all conversations about our patients and their health care needs. In every country in the world nurses are facing similar challenges but we can learn together and from each other.

We need to help our political leaders to make the right decisions to respond to constant change and unforeseen risks while keeping the interests of future generations in mind?

The flux of resources — human and material — is characterized by a predominantly unilateral trend that has a major impact on quality of life in deprived regions. The massive migration of workforce, researchers and funds out of low income countries disrupts already frail ecosystems and drains them from their lifelines, leaving populations at risk, lowering their quality of health and depriving them from the appropriate means to prevent and treat illnesses. Higher income countries have benefitted from these movements; their booming economies attract qualified professionals worldwide and become hubs for innovation.

Added to this are some of the very real challenges Colombian nurses are facing; issues such as gender violence, poor working conditions, low remuneration and budget cuts.

In this contrasted climate, the danger of equality gaps growing to a point of no return is alarmingly real but the answer to curb this tendency lies in the hands of the collectivity. This is precisely the intent behind the United Nations’ Sustainable Development Goals (SDGs), which has established 17 precise interrelated targets that each and every one of us has the potential to achieve. International Council of Nurses’ (ICN) is working for you to influence global leaders of the role that nurse have to play in achieving these goals. It is no secret that universal health cannot happen without nurses.

If this is true for the general public, for nurses, it is an inherent part of our professional practice.

As we showcased in our 2017 International Nurses Day resource ( through numerous real-life examples, nurses are the best placed group of professionals to advocate and lead the quest to reach universal health coverage (UHC) by the year 2030, but also play a key role in tackling many of the other SDGs which impact health: poverty, pollution, gender inequality and climate change, to name a few.

This crucial role was recently brought to the forefront of the World Health Organization’s agenda notably through its newly elected Director General, Dr. Tedros Adhanom Ghebreyesus. Addressing the over 8000 nurses at the ICN 2017 Congress this past June, Dr. Tedros made the strong statement: “There is no doubt in my mind that nurses are a lynchpin of this effort.” He also reaffirmed his commitment to consult with and involve nurses in his mandate, noting that the profession holds a unique perspective on the communities it cares for.

Putting his words into action, Dr. Adhanom announced the appointment of a senior nurse role on his own team.

The many and varied roles of nurses in primary and community settings allows empowering patients to be in control and at the centre of their own healthcare and better integrating and redesigning health services around people. In Colombia, nurses need to take on stronger leadership roles, promoting the work they are doing to tackle the social determinants of health such as poverty and inequality. Colombian nurses are often invisible in clinical records and in positions of leadership. By stepping up and speaking out for changes in public policies to improve working conditions, minimize occupational hazard, improve nursing education, etc. nurses in Colombia and around the world can make a difference!

The kind of involvement was exemplified more recently by ICN’s participation in the World Health Organization Global Service Delivery Network for universal health coverage first meeting. Bringing nurses’ holistic perspective at the highest levels of decision making is necessary if we are to build resilient health systems. Nurses have the capability and the duty to lead innovation and policy making and that is central to what ICN strives to do: Bring nurses voices to the table.

At ICN, we are actively committed to continue to collaborate with international organisations such as World Health Organization and the United Nations and through our member National Nurses Associations in over 130 countries, we make sure nurses have the means and tools to be at the heart of political efforts at the local and global level.

We are also currently consulting on strategies related to the very challenges of global nursing —which are also our priority areas—Ageing, Non-Communicable Diseases, Mental Health, Immunisation and Antimicrobial Resistance.

But we are also fully aware that the issue of Human Resources for Health is vital to any conversation around the achievement of the SDGs and UHC. ICN was extremely active in the development of the Global Strategy on Human Resources for Health: Workforce 2030 and the United Nations Commission on Health Employment and Economic Growth. We will continue this activity through the Nursing Now Campaign which will be launched in January 2018 and the upcoming 4th Global Forum on Human Resources for Health to be held in Dublin in November this year.

I encourage you to review our International Nurses Day resources and evidence and share your story with us via

Nurses in Colombia are represented at ICN through the Asociación Nacional de Enfermeras de Colombia and although I understand how difficult it for you to give time to your nursing association, both with your work and personal commitments, I strongly encourage you all to learn how you can participate in your local, national and the global health agenda. It is only the collective voice of nurses in your country that will bring improvements for your working conditions and the quality of care that you give to your patients.

I look forward to visiting your country during my presidency and meeting all of you and wish you every success in your careers.