International Day of Midwives, 5 May 2019 and International Nurses Day, 12 May 2019

Message from Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region on the occasion of International Day of Midwives, 5 May 2019 and International Nurses Day, 12 May 2019

The year 2020 is likely to be a special one for nursing, midwifery and the quest to achieve universal health coverage (UHC). As per WHO's Executive Board proposal in January (and pending its adoption at the World Health Assembly later this month), 2020 will be the Year of the Nurse and Midwife, in honour of the 200th birthday of Florence Nightingale, the founder of modem nursing. Given the importance nurses and midwives have in providing frontline care, the proposed celebration would resonate across the WHO South-East Asia Region, which since 2014 has pursued UHC as one of its Flagship Priorities.

In recent years, progress in recruiting and training nurses and midwives has been strong. As the Region's Decade for Strengthening Human Resources for Health 2015—2024 demands, the density of nurses and midwives has substantially increased, from 15.7 per 10 000 people in 2014 to 19.8 per 10 000 people just three years later. This made possible by the development and implementation of national plans on nursing and midwifery, with several countries introducing specialized and updated midwifery programmes to help achieve the Flagship Priority of ending preventable maternal, new-born and child deaths, with a focus on neonatal deaths.

The drive to sustain and accelerate this momentum continues, as it must. Though the number of nurses and midwives has increased, for example, WHO estimates the world needs an additional 7.6 million nurses and midwives by 2030, with the South-East Asia Region accounting for a disproportionate share — 1.9 million. Moreover, substantial disparities in access to skilled birth attendants — including nurses and midwives — persist between rural and urban areas, compounding health inequities. Data on the nursing and midwifery workforce continue to remain scarce, while capacity with regard to documentation, the transformation of evidence into policy, and multi-sectoral collaboration must be enhanced.

To surmount these challenges, increase the number, skills and equitable distribution of nurses and midwives Region-wide, and accelerate towards UHC, several interventions should be scaled up.

First, nursing and midwifery education and training should be strengthened to produce a workforce with the skills required to meet patient needs throughout the life-course. While there are many types of pre-service education and in-service training available, the capacity of nursing and midwifery faculties should be enhanced via a competency-based curriculum that includes a sufficient amount of clinical training.

Second, intra- and interprofessional collaboration should be promoted wherever possible to create a diverse and highly skilled health workforce. While nurses and midwives are often the only health care professionals available at frontline services, at other levels of care they are part of interdisciplinary teams. This provides opportunities for collaboration and the upskilling of all health workers, which will increase access to skilled health care providers.

Third, leadership, management and governance of the nursing and midwifery workforce should be fortified. By doing so, the ability for nurses and midwives to contribute to policy development, programme planning and implementation will be optimized through the creation of leaders who have the expertise and insight to inform decision-making. The WHO-supported Nursing Now campaign is a good example of how this can be achieved, with benefits accruing to all who are willing to challenge themselves.

Fourth and finally, investment in nursing and midwifery must be increased, As the UN High Commission on Health Employment and Economic Growth has outlined, doing so will result in a 'triple return' that improves health outcomes, enhances health security and spurs economic growth. Given that nurses and midwives account for more than half of the health workforce, investing in nursing and midwifery should be identified as one of the core ways to strengthen frontline services and make significant inroads towards UHC and the benefits it will bring.

As we mark the International Day of the Midwife today, and International Nurses Day in a week's time, WHO commends the efforts of health workers in each profession and reiterates their primacy in providing quality frontline services and in the pursuit of UHC. As always, WHO is committed to delivering ongoing support to Member States to ensure they can marshal an adequate number Of dedicated, competent and equitably distributed nurses and midwives, and advance the quest to achieve UHC across the South-East Asia Region and beyond.

Dr Poonam Khetrapal Singh
Regional Director