It is almost ironic that the World Health Organisation (WHO) had designated 2020 as the “International Year of the Nurse and the Midwife,” in honor of the 200th anniversary of Florence Nightingale’s birth as the world gained an unprecedented respect for its healthcare systems as the coronavirus pandemic unfolded.
Bestowing this designation provides an opportunity to not only drive recruitment as the world faces a growing shortage of nurses and midwives, but more importantly highlight the everyday miracles carried out by nurses and midwives across the globe as the backbone of the health services.
The purpose of this year is to elevate nursing throughout the world and help people recognise the many roles that nurses play in global healthcare. But just as the year began, the coronavirus pandemic helped to illustrate the critical role that nurses and midwives play in a crisis – despite the pressure that the outbreaks placed on individual health services, nurses and midwives rose – and are rising – to the challenge, even in the face of phenomenal risk to their own health and wellbeing.
“Nurses and midwives are the backbone of every health system: in 2020 we’re calling on all countries to invest in nurses and midwives as part of their commitment to health for all,” commented Tedros Adhanom Ghebreyesus, the WHO Director-General, at the beginning of 2020.
According to The State of the World’s Nursing 2020 report, 59% of all healthcare professionals are nurses and the global workforce of nurses is currently around 28 million, of which 19.3 million are professional nurses, 6 million are associate professional nurses and the remainder are not classified. And although the global nursing shortage has reduced from 6.6 million estimated in 2016 to around 6 million in 2018, the report’s warning is that by 2030, there will be a need for 36 million nurses practicing across the world to meet the needs of every individual on the planet.
The global shortfall of 5.9 million is mainly concentrated in parts of Africa, South East Asia and the WHO Eastern Mediterranean region as well as some parts of Latin America.
The report highlights the need for governments to invest in and address the areas of nursing education, nursing recruitment, and nursing leadership and includes 10 Sustainable Development Goals.
The report also highlights the staggering global inequality when it comes to healthcare: more than 80 per cent of the world’s nurses work in countries that are home to half of the world’s population. Countries also find it difficult to retain nursing staff: one in every eight nurses practices in a country other than the one where they were born or trained. Worrying, nursing is an ageing profession, with one out of six of the world’s nurses expected to retire in the next 10 years.
Midwives and a positive birth experience
“Midwives risk their own lives to save those of pregnant women and newborns. They ensure safe and healthy pregnancies, taking every precaution to protect the women they serve,” commented UNFPA Director Dr Natalia Kanem on World Health Day earlier this year.
“Midwives who serve patients outside of hospitals are crucial to maintaining the safe distancing measures necessary to curb the spread of the disease. The more midwives who are ready to visit the homes of pregnant women in rural communities or who can offer phone-based antenatal and post-natal care, then the more people able to avoid transmitting or becoming infected by the coronavirus.
“While the novel coronavirus sweeps the world, including many developing countries with fragile health systems, women continue to get pregnant and give birth. Midwives are essential to ensure safe pregnancies and births for everyone, everywhere. They also provide the information and contraceptive counselling that women and young people need, even in times of crisis,” she said.
In the UK midwives deliver half of all babies, while in Sweden, Norway and France, midwives oversee most expectant and new mothers, meaning obstetricians are free to concentrate on high-risk births. In Canada and New Zealand, midwives are so highly valued that they’re brought in to manage complex cases that need special attention.
In 2012, the WHO issued guidelines that recommend that midwives take the lead in providing care through pregnancy, childbirth, and afterwards. They stated that this “continuity of care” is not only preferred by women, but has been proved to reduce preterm births by 24%, which is a key factor in improving infant health.
Indeed, research has shown that midwifery care is strongly associated with lower interventions, cost-effectiveness and improved outcomes. It has also been estimated that midwives who are educated to international standards and work in a functional health system can meet 87 percent of all women and newborns’ healthcare needs.
As the Year of the Nurse and Midwife continues, during Safe Motherhood Week 2020, we have taken inspiration with our theme: Working together with midwives & nurses for a positive pregnancy experience in a post COVID-19 era. Every woman deserves a positive pregnancy experience and nurses and midwives enable and ensure that.