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Ensuring the Critical link in Health Care: Nurses and Midwives

If asked what one remembers from the last hospital visit for your child, we should not be surprised if the first person who crosses one’s mind is the nurse who shared a kind word even as she immunized your child gently, the re-assuring hands that started an I.V. and assured you that your child will be better soon, the pause the nurse took to answer your question even as she had to rush to complete the recording of vital signs for another patient.

This World Health Day 2020 – the International Year of the Nurse and the Midwife, “we honour the contribution of Nurses and Midwives, recognizing their vital role in keeping the world healthy”, says WHO. Nurses and other nursing associated health workers, making up two-thirds of the health work force globally, are one of the most valuable resources of every country. They are at the frontlines of this COVID-19 response too, putting their own lives at risk to protect the wider community.

World Health Day presents an opportunity to advocate for commitment and resources to advance ‘Health for all’ globally. Since its inception at the First Health Assembly in 1948 and taking effect in 1950, the celebration has aimed to create awareness of specific health themes to highlight a priority area of concern for the World Health Organization.

Nursing in India can be traced all the way to ancient times. In modern times, the influence of Florence Nightingale is worth remembering. She had great influence over nursing in India given her extensive work with the army. Her interest in extending nursing to the civil society led to foundational work and the establishing of nursing system for hospitals in India. St. Stephen’s Hospital, Delhi was the first hospital to begin training Indian women as nurses. The Indian Nursing Council was established by ordinance on December 31, 1947 and the council was constituted in 1949.

A lot of progress has been made since. There was a time when professional nurses had very little choice of service because nursing was centered in the hospital around bedside nursing. A staff nurse provided direct patient care to one patient or a group of patients, assisted ward management and supervision. Today, career opportunities are more varied for a number of reasons. Almost every specialty in medicine from Obstetrics to Psychiatry needs specialized training. These trainings, available for both Doctors and Nurses, allow for a holistic approach to health care.

Over the past 50 years, this team effort (most importantly including nurses) rather than the traditional Doctor led approach has brought to light important health issues such as mental health, gaps in maternal and child care, and impact of climate change (such as epidemics). The World Health Day celebration is marked by activities which extend beyond the day itself and serves as an opportunity to focus worldwide attention on these aspects of global health.

Some facts to reflect on:

 Majority (75%) of the health work force comprises women; nurses account for great numbers within that.
 Both men and women nurses service the vast health care institutions of the world, but better compensation for nurses remains an area to be addressed.
 Investment in high quality education of nurses is still much needed.
 The North American model of having ‘nurse practitioners’ as active members of the Primary health care dispensing team is well studied and highly recommended. However, it is yet to be implemented worldwide.
 In the Western Pacific region, one nurse out of three (33%) is born or trained in a country other than their current country of practice.
 Shortage of nurses is there in every country. 89% of this shortage is concentrated in low and lower middle-income countries.