Global Health and Nursing
Sheila R. Bonito, Luz Barbara P. Dones
LEARNING OBJECTIVES
Upon completion of this chapter, the reader will be able to:
• Discuss global health issues post-COVID-19 pandemic and implications for nursing
• Analyze the Sustainable Development Goals and how nurses contribute to their attainment
• Define universal health coverage and its potential impact on health and nursing
• Explain primary health care as an approach to achieving universal health coverage
• Describe the work of international organizations in achieving Sustainable Development Goals
and universal health coverage
• Discuss the global strategies in nursing and midwifery to deliver universal health coverage,
and Sustainable Development Goals (SGDs)
KEY TERMS
Building Blocks of Health Systems
Burden of Disease
Communicable Diseases
Global Action Plan
Global Health
Global Health Players
Global Strategic Directions in Nursing and Midwifery
Healthy Life Expectancy
Human Resources for Health
Life Expectancy
Noncommunicable Diseases
Primary Health Care
Social Determinants of Health Sustainable Development Goals
Universal Health Coverage
Global Health Issues
Global health is an area for study, research, and practice that places a priority on improving
health and achieving equity in health for all people worldwide; emphasizes transnational health
issues, determinants, and solutions; involves many disciplines within and beyond the health
sciences, promotes interdisciplinary collaboration; and is a synthesis of population-based
prevention with individual-level dinical care (Koplan et al., 2009). Global health requires global
cooperation in response, planning, prevention, preparedness, care that reflects health equity
issues among countries (Edmonson et al., 2017). The nature of these global health issues and
the factors that influence them also need interprofessional and interagency cooperation from the
public and private sectors.
The world is off track to reach most of the
WHO Triple Billion targets and the health-related Sustainable Development Goals (SDG).
The triple billion targets involve one billion more people benefitting from universal health
coverage, one billion more people better protected from health emergencies, and one billion
more people enjoying better health and well-being by 2025. In terms of health and well-being,
significant improvements in air quality and access to water, sanitation, and hygiene measures
will likely lead to better health and well-being of 1 billion people; however, it will be insufficient to
reach all the health-related targets of the Sustainable Development Goals by 2030 (World
Health Organization [WHO|, 2023a). In terms of universal health coverage, 30% of countries are
making progress on the coverage of essential health services and the provision of financial
protection. However, the disruptions caused by the COVID-19 pandemic to many indicators
require concerted efforts to close the gaps. Improvements in emergency and disaster
preparedness, as measured through core capacities related to the International Health
Regulations (International Health Regulations,
2005), made a positive contribution in 20222023. Efforts are continuing to assess the best way to measure protection from health
emergencies, including the integration of timeliness targets for detection, notification, and
response to health emergencies (WHO, 2023a).
Life Expectancy and Healthy Life Expectancy
The COVID-19 pandemic has had devastating impacts on the health of populations across the
globe. In just two years, the COVID-19 pandemic reversed over a decade of gains in both life
expectancy at birth and healthy life expectancy. Global life expectancy at birth dropped by 0.7
years to 72.5 (unit interval or UI: 71.9-73.1) years in 2020, and by a further 1.1 years to 71.4 (Ul:
70.8-72.0) years in 2021 (WHO, 2024). Similarly, global healthy life expectancy dropped to 62.8
(UI: 62.0- 63.7) years in 2020 and 61.9 (UI: 61.1-62.8) years in 2021 (World Health Organization
[WHO|,
2024). These reversals in life expectancy and healthy life expectancy for 2020 and 2021
brought Figures back to the level of 2016 and 2012 respectively (WHO, 2024).
In terms of income groups, as categorized by the World Bank, life expectancy was cut by 0.6
years in low-income countries and by 2.4 years in lower-middle-income countries between 2019
and 2021. Comparing the two income groups in a similar period, healthy life expectancy was cut
by 0.6 years and 2.0 years, respectively. The first year of the pandemic
(2020) hit hardest the upper-middle-income and high-income countries while the
low-middle-income countries were hit hardest in 2021 with over 70% of the decline in life
expectancy and healthy life expectancy (Figure 14.1)
The highest increases in global life expectancy have come from progress against enteric
diseases, including diarrhea and typhoid. This reflects better public health interventions on
unsafe water, sanitation, and handwashing.
On the other hand, the largest decreases in life expectancy have come from COVID-19 and
COVID-related causes. Diabetes, and kidney diseases have also contributed to the decline in
life expectancy from 2020 onwards (Figure 14.2).
Shifting Burden of Disease
Aside from the setback in life expectancy and healthy life expectancy, the COVID-19 pandemic
also reversed the trend of shifting the disease burden to noncommunicable diseases (NCDs).
Deaths due to communicable diseases (CD) rose to 23.0% in 2020 and 28.1% in 2021,
returning to levels seen in 2012 and 2005, respectively (WHO, 2024). The Global Burden of
Disease Study 2021 showed that the leading cause of death worldwide in 2019 and 202i
changed significantly due to COVID-19 (Figure 143).
Deaths from COVID-19 and other pandemic-related mortality were the Top 2 and Top 5 causes
accounting for 92 and 32 death rates (per 100,000) respectively. The COVID-19 pandemic
eversed the declining trend in age standardized death rates for communicable diseases in all
income groups to the extent that the level in
Years of life expectancy gained or lost from leading causes of death globally, 1990-2021
Noncommunicable Diseases (NCDs)
For NCDs in 2016, the largest number of deaths were caused by cardiovascular diseases (17.6
million deaths) followed by neoplasms or cancer (8.93 million deaths), and chronic respiratory
diseases (3.54 million deaths).
Globally, deaths from cardiovascular disease increased by 14.5% between 2006 and 2016.
Ischemic heart disease and cerebrovascular disease (stroke) combined accounted for more
than 85.1% of all cardiovascular disease deaths in 2016. Total deaths from ischemic heart
disease rose by 19.0%, increasing from 7.96 million deaths in 2006 to 9.48 million deaths in
2016, which largely accounts for the overall increase in total deaths from cardiovascular
diseases. The absolute number of deaths and the total years of life lost (YLLs) from diabetes
both increased between 2006 and 2016 by 31.1% and 25.3%, respectively. Deaths from
neoplasms increased globally by 17.8%, rising from 7.58 million deaths in 2006 to 8.93 million
deaths in 2016.
From 2006 to 2016, increases of greater than 30% occurred for several neoplasms that were
major causes of death: prostate cancer (30.8%, to 381,000 deaths); pancreatic cancer (30.2%,
to 405,000 deaths); and other neoplasms (30.0%, to 431,000 deaths). Both lung cancer and
breast cancer deaths increased from 2006 to 2016, from 1.44 million deaths to 1.71 million
deaths for lung cancer and from 466,000 deaths to 546,000 deaths for breast cancer. Chronic
respiratory diseases contributed 8.96% of NCD deaths in 2016, with chronic obstructive
pulmonary disease (COPD) leading to the most deaths from these conditions (2.93 million
deaths).
A steady decline in premature mortality from NCDs in recent years has been observed due to
improved prevention, diagnosis, and treatment. In 2000, a person aged 30 years had a 22.7%
(Ul: 18,7-27,2%) chance of dying from one of the four major NCDs (cardiovascular disease,
cancer, chronic respiratory disease, and diabetes) before the age of 70 years. This risk fell to
18.2% (Ul: 14.2-23,0%) in 2019, before the onset of the pandemic, corresponding to an
approximately 20% reduction (WHO, 2024).
Global Burden of Disease (GBD) 2021 reveals that diabetes experienced the most rapid growth
among the different causes of poor health, referred to by researchers as years lived with
disability. Age-adjusted years lived with disability due to diabetes rose by 25.9% between 2010
and 2021. Poor health from diabetes increased in every country and territory that the
researchers studied (IME, 2024).
High blood pressure, smoking high blood sugar, and ambient particulate matter air pollution are
among the leading risk factors, globally and at each level of the socio-demographic index. Policy
interventions to date have been insufficient to address rising exposure to risk factors including
high body mass index, high blood sugar, ambient air pollution, drug use, and high temperatures
(IHME, 2024).
During the COVID-19 pandemic, some countries experienced a slowdown in the reduction of
NCDs or even an increase in NCD mortality because of disruptions to healthcare services.
Patients with NCDs were also in greater risk of dying prematurely from COVID-19.
There are still many unknowns around the progress in NCD premature mortality during the
COVID-19 pandemic to have a better picture of its global burden.
Injuries
Unintentional injuries accounted for the most injury deaths in 2016, with 1.80 million deaths
primarily from deaths from falls (678,000 deaths), drowning (302,000 deaths), and
exposure to
mechanical forces (155,000
deaths). Unintentional injuries were followed by transport injuries (1.44 million deaths), and
self-harm and interpersonal violence (1.21 million deaths). Deaths from physical violence by
firearm were the largest portion (41.2%) of overall interpersonal violence in 2016. Self- and
faced health inequities due to avoidable, unfair, and unjust factors. These health
challenges affect persons with disabilities, refugees, and migrants. Access to health care is
often limited for refugees and migrants. Lack of quality data further obstructs understanding of
their needs and monitoring progress on health goals. Progress requires strengthening health
systems that integrate targeted actions to increase equity.
Nursing as a profession is ideally positioned to engage its members as key participants in both
human rights and global health diplomacy efforts (Breda, 2012). Nurses can collaborate in
interprofessional efforts to improve health and enhance human rights and international relations
efforts. As health issues become more global and extend beyond healthcare to include foreign
policy, security, and trade agreements, nurses can also take on leadership roles to examine
health within the broader context of global political and economic power.
Sustainable Development Goals and
Universal Health Coverage
The United Nations General Assembly (UNGA) meeting in New York in September 2015 under
the theme, "Transforming our world; the
2030 Agenda for Sustainable Development®, adopted 17 Sustainable Development Goals
(SDGs) as the post-millennium development goals (Figure 14.4). These goals aim to ensure that
all human beings can fulfill their potential in dignity and equality and a healthy environment."
The SDGs lay the foundations for supporting global health and international development work
from 2015 to 2030. This requires multisectoral and multi-stakeholder partnerships, and
embedding in national plans and policies, and building capacity (United Nations [UN], 2024).
SDG 3: Good Health and Well-being One goal specific to health is SDG 3, which aims to ensure
healthy lives and promote well-being for all at all ages" and addresses the unfinished Millennium
Development Goals (MDGs) and emerging challenges such as NCDs, health security, tobacco
use, and injuries (WHO, 2017a).
Other SDGs Related to Health
• SDG 3 is linked to approximately 50 health-related targets across the SDGs. These SDGs
include core health targets, contribute to health and well-being, and commit to "leave no one
behind."
• SDG 1. Extreme poverty/ Vulnerability to economic, social & environmental shocks and
disasters
• SDG 2. Malnutrition
• SDG 5. Violence against women and girls/ Sexual and reproductive health and rights
• SDG 6. Safe and affordable drinking water/ Sanitation and hygiene
• SDG 8. Safe and secure working environment
• SDG 11. Housing and basic services/ Air quality and waste management in cities
• SDG 13. Climate-related hazards and natural disasters
Achieving health in the SDGs means addressing barriers to access to health services,
whether
financial, physical, geographic, educational, or cultural, especially those faced by socially
excluded and disadvantaged groups. It is a whole-of-system approach to improving health
system performance and sustaining health gains. It prioritizes people and communities, calling
for health systems that are of good quality, efficient, equitable, accountable, resilient, and
responsive to the needs of diverse population groups, including those left furthest behind (WHO,
2017a).
Achieving universal health coverage (UHC) is one of the overarching targets of the 2030
agenda for sustainable development, under SDG 3. Universal health coverage is based on the
principle that all people should have access to the health services they need and not suffer
financial hardship while accessing the services.
Among the health targets for SDG 3, Target 3.8 emphasizes the importance of universal health
coverage to attain equitable and sustainable health outcomes and improve the well-being of
individuals and communities.
WHO's view of Universal Health Coverage
(UHC) means that all individuals and communities receive the health services they need without
suffering financial hardship. Such services include the full spectrum of essential, quality health
services from health promotion to prevention, treatment, rehabilitation, and palliative care (World
Health Organization [WHO], 2019a). By making quality health services accessible to everyone,
people will not run the risk of losing their money, savings and assets when they suddenly
become ill. UHC enables countries to achieve their health targets towards other economic and
development goals.
UHC is measured by a country's health service coverage and financial protection.
Health Service Coverage and Financial Protection
UHC progress is monitored using two indicators:
(1) health service coverage or the proportion of the population that can access essential quality
health services and, (2) financial protection, or the proportion of the population that spends a
large amount of household income on health (Figure 14.5).
WHO, 2019a uses 16 essential health services in four categories as indicators of the level and
equity of coverage in countries:
• Reproductive, maternal, newborn and child health (RMNCH) which include services on family
planning, antenatal and delivery care, full child immunization and health-seeking behavior for
pneumonia
• Infectious diseases covering services for tuberculosis treatment, HIV antiretroviral treatment,
hepatitis treatment, use of insecticide-treated bed nets for malaria prevention and adequate
sanitation
• Noncommunicable Diseases that include services for prevention and treatment for raised
blood pressure and blood glucose, cervical cancer screening and tobacco smoking
• Service capacity and access to basic hospital and health worker services, essential medicines,
and health security
COVID-19 impacted the progress of UHC due to a worsening of service coverage and financial
protection during the pandemic. The combined macroeconomic, fiscal, and health impacts of the
pandemic, and emerging evidence on rising poverty, led to the weakening of financial protection
globally, with higher rates of forgone care due to financial barriers and more people incurring
financial hardship due to catastrophic and impoverishing out-of-pocket spending (WHO, 2023a).
Strengthening Health Systems
Countries that have made strides toward UHC have demonstrated the need to increase the
resilience of their health systems to respond to local and global health threats. Kieny et al.,
(2017) define health system strengthening as a significant and purposeful effort to improve
system performance and embody the intermediary objectives of the national health policies,
plans, and strategies which include quality, equity,
efficiency,
accountability,
resilience, and sustainability.
Figure 14.6 illustrates how strengthening the health systems contributes to the attainment of
SDG through UHC. Action refers to interventions that aim at strengthening the health system.
Whether people are healthy or not, is determined by their circumstances and environment.
These determinants of health indude the social and economic environment, the physical
environment, and the person's characteristics and behaviors.
Six building
blocks contribute to the
strengthening of health systems. Key input components to the health system include health
financing and health workforce, while medical products and technologies and service delivery
reflect the immediate outputs of the health system.
Leadership/ governance and health information systems provide the basis for the overall policy
and regulations of all the other health system blocks. Health systems strengthening requires
good governance, well-functioning health information systems, a robust financing structure, a
sound system of procurement and supply of medicine and health technology, and and, finally,
available, accessible, and skilled healthcare professionals to deliver high-quality
people-centered integrated care (WHO, 2010;
WHO, 2019a).
Health financing arrangements determine the ability of health systems, to respond to health
needs, pool financial risks, and operate efficiently and equitably. Healthcare professionals are
the cornerstone of a resilient health system and global health challenges and population
changes are driving the need for more healthcare professionals. It is critical to address the
global shortage of healthcare professionals, ensuring not only adequate numbers but also
proper distribution in local areas and alignment with population health needs. Service delivery
includes a wide range of health service providers, including public healthcare institutions
and other entities responsible for essential public health functions and the provision of
healthcare products. Access to medicines and
health technologies was highlighted during the
COVID-19 pandemic, especially the need for innovation and local production to enhance the
equitable distribution of healthcare products (eg., medicines, vaccines, diagnostics, and
devices) (WHO, 2024).
Primary Health Care
It has been four decades since the 1978 Alma-Ata Declaration that Primary Health Care
(PHC) was the way to achieve health for all by the year 2000. PHC as a concept, philosophy,
and approach received much criticism as it was misunderstood. In the mid-1990s, the global
health scenario characterized by the HIV/AIDS epidemic, and the resurgence of TB and malaria,
prompted the WHO to review its approaches to address these emergencies. The start of the 21
century saw the MDGs being put forward as a framework for development cooperation.
In 2010, the WHO commissioned a report on universal health coverage which became central to
the SDGs (WHO, 2017b).
Reiterating the earlier definition, PHC is an approach to health and well-being centered on the
needs and circumstances of individuals, families, and communities and addresses
comprehensive and interrelated physical, mental, and social health and well-being (WHO,
2019a). PHC looks at the person's health holistically; and not just addressing disease or illness
conditions. It also emphasizes the services being delivered in places where the people live or as
close to where they live.
WHO's definition of PHC is based on three components:
• Ensuring people's health problems are addressed through comprehensive promotive,
protective, preventive, curative, rehabilitative, and palliative care throughout the life course,
strategically prioritizing key system functions aimed at individuals and families and the
population as the central
elements of integrated service delivery across all levels of care
• Systematically addressing the broader determinants of health (including social, economic, and
environmental as well as people's characteristics and behaviors) through evidence-informed
public policies and actions across all sectors; and
• Empowering individuals, families, and communities to optimize their health, as advocates for
policies that promote and protect health and well-being as co-developers of health and social
services through their participation, and as self-carers and caregivers to others.
To achieve UHC, health systems must be oriented towards a primary health care (PHC)
approach, which includes three essential components: multisectoral policy and action;
empowered people and communities; and primary care and essential public health functions at
the core of integrated health services.
Strengthening PHC aims to provide strong health system foundations and to maintain essential
health services to ensure healthy lives and promote well-being for all ages, leaving no one
behind. Through multisectoral actions, PHC intends to reduce risk factors and prioritize health in
all policies and healthy settings.
Global Health Players
In response to the work needed to achieve health-related SDGs, twelve (12) multilateral
international organizations with significant roles in health, development, and humanitarian work
came up with a Global Action Plan to strengthen their collaboration in support of countries.
The Global Action Plan (WHO, 2019b) builds on existing mechanisms, including country
platforms for achieving the SDGs and the ongoing process of reform in the United Nations
Development System. Their commitments are:
• Engage with countries better to identify priorities and plan and implement them
together
• Accelerate progress in countries through joint actions under seven accelerator themes set out
in the Plan, and through an overarching commitment to advance gender equality and support
the delivery of global public goods
• Align by harmonizing operational and financial strategies and policies in support of countries
where this increases our efficiency and reduces the burden on countries; and
• Account by reviewing progress and learning together to enhance shared accountability.
Figure 14.7 lists the 12 organizations who recognized the needed closer collaboration to help
accelerate progress towards the health-related SDGs and committed to a Global Action Plan
(WHO, 2019b).
Role of Nurses in Global Health
Addressing global health issues and achieving the SDGs through universal health coverage and
primary health care requires the commitment of all healthcare professionals. Nurses being at
the forefront of the health care delivery system are expected to help accelerate progress
towards achieving these. Nurses have the greatest potential since they are well positioned in
many settings from academic institutions, public health, dinical care, government, and private
agencies, possessing various roles as leaders, managers, direct carers, researchers, and policy
advocates.
However, some challenges must be faced.
Nurses must recognizeand understand howsocial determinants impact on health of individuals
and populations. Nurses must advocate for addressing these social determinants of health and
health inequities 10 help individuals, families, and communities achieve better health.
Nurses in the different levels of care across the health system must know how to
implement, and evaluate programs and policies that would better address local, national, and
global health issues. Furthermore, nurses need to become human rights advocates, political
activists, engaged citizens, and critical artists for global health issues, and acquiring these roles
requires that they have a sound understanding of globalization and the political economy of
health, as well as a solid knowledge base in human rights and global health diplomacy (Breda,
2012).
There is also a need to address the nursing shortage and workforce maldistribution in many
countries. The International Council of Nurses actively participated in drafting the WHO Global
Strategy on Human Resources for Health: Workforce 2030 (White, 2016). The Global Strategy
has the vision: "Accelerate progress towards Universal Health Coverage and the Sustainable
Development Goals by ensuring equitable access to skilled and motivated healthcare
professionals within a performing health system." This was further supported by the goal:
"Ensure availability, accessibility, acceptability, and quality of the health workforce through
adequate investments and the implementation of effective policies at national, regional and
global levels, for ensuring healthy lives for all at all ages, and promoting equitable
socio-economic development through decent employment opportunities." (Global Health
Workforce Alliance & WHO, 2015).
Nurses can contribute as leaders of change to help address global health issues, achieve the
SDGs, and implement universal health coverage and primary health care. Nurses can contribute
by becoming involved in communities and professional nursing organizations, and getting
involved in policymaking and advocacy organizations, and being active in their workplaces.
The impact of the COVID-19 pandemic has reinforced the global need for skilled nurses and
midwives. In May 2021, the Seventy-fourth World Health Assembly (WHA) adopted the Global
Strategic Directions for Nursing and Midwifery (SDNM) 2021-2025 under WHA
74.15 resolution.
Global Health Players for Achieving the SDGs
Gavi, the Vaccine Alliance
Is a oublic private partnershio committed to saving children's lives and protecting peoole's health
by Increasing equitable use of vaccines in lower income countries. The Vaccine Alliance brings
together developing country and donor governments, the World Health Organization, UNICEF,
the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates
Foundation and other private sector partners. Gavi uses innovative finance mechanisms to
secure sustainable funding and adequate supply of quality vaccines. Since 2000, Gavi support
has helped countries immunize more than 760 million children. This has helped to reduce
deaths from vaccine-preventable diseases by more than
60 per cent and played a key role in halving the under-five mortality rate in those countries.
IThe Global Financing Facility (GFF) for Women, Children and Adolescents
Is a multi-stakeholder partnership that supports efforts to tackle the greatest health and nutrition
issues affecting women, children and adolescents in low and lower middle income countries
around the world.
The CEC cunnarts government led olatforms that bring together key partners to develoo a
orioritizad health olan and mobilize sustainable financina for health and nutrition. The GFF Trust
Fund acts as a catalyst for financing, with countries using modest GFF Trust Fund grants to
significantly increase their domestic resources alongside World Bank financing, aligned external
financing and private sector resources. The GFF partnership is currently working in 36
countries, with the aim of expanding to 50 countries by 2023.
The Global Fund to Fight AIDS, TB and Malaria
Is a partnership designed to accelerate the end of AIDS, tuberculosis and malaria as epidemics.
As an international organization, the Global Fund mobilizes and invests more than $4 billion a
year to support programs run by local experts in more than 100 countries. In partnership with
governments, civil society, technical agencies, the private sector and people affected by the
diseases, the Global Fund is challenging barriers and embracing innovation.
The Joint United Nations Programme on HIV/AIDS (UNAIDS
Leads and inspires the world to achieve a vision of zero new HIV infections, zero discrimination
and zero AIDS-related deaths. UNAIDS works for an inclusive, multisectoral response to HIV
that is people-centered, integrated in the 2030 Agenda and grounded in a respect for human
rights and gender equality, ensuring that people living with and affected by HIV are meaningfully
involved in the response. UNAIDS is a unique joint program that unites the efforts of 11 UN
organizations through a common budget and workplan to end AIDS as a public health threat as
part of the Sustainable Development Goals. UNAIDS provides the strategic direction, advocacy,
coordination, strategic information and technical support needed to catalyze and connect
leadership from governments, the private sector and communities to deliver life-saving HIV
services.
The United Nations Development Programme (UNDP
is one of the world's largest multilateral development agencies, present in over 170 countries
and territories and on the frontines of anticipating, understanding and acting on today's
opportunities and risks. The 2030 Agenda, the Sustainable Development Goals and the pledge
to leave no one behind provide a holistic blueprint for change - an integrated plan to end
poverty, protect the planet and ensure. that all people enjoy lasting peace and prosperity.
UNDP's role is to help governments and actors throughout society to power and accelerate their
progress towards the SDG, while keeping the global development dimensions of health in over
100 countries.
vision intact and on track. In this context, UNDP supports countries to address the determinants
and The United Nations Population Fund (UNFPA)
Is the United Nations agency working to deliver universal access to sexual and reoroductive
health, including voluntary family planning and safe motherhood, and to advance the rights and
opportunities of young people. UNFPA also helps countries use population data to anticipate
tomorrow's challenges and is present in more than 150 countries and territories. UNFPA works
from the international to local level, from providing governments with technical guidance, policy
advice, training and support to delivering
services and supplies to those who need them most.
Figure 14.7 Global health players in achieving the SDGs.
Global Health Players for Achieving the SDGs
The United Nations Children's Fund (UNICEF)
Works with its partners in 190 countries and territories to promote the richts and wellbeina of
every child and translate that commitment into practical action. UNICEF takes a lifecycle based
approach in all its work, recognizing the particular importance of early childhood development
and adolescence, its programmes focus on the most disadvantaged children, the poorest and
most vulnerable, those in fragile contexts, with disabilities, and those affected by rapid
urbanization and by environmental degradation.
UNICEF works with others to overcome obstacles and give children the best start in life as the
strongest foundation for their future. UNICEF has strong partnerships with governments and
other organizations at national and sub national levels. It works to bring practical solutions to
children and women at greatest risk and ensure children's survival, growth and development.
Unitaid
Is a global development agency engaged in finding innovative solutions in global health,
including new ways to prevent, diagnose and treat diseases more quickly, cheaply and
effectively, in low and middle income countries. Its work includes funding initiatives to address
major diseases such as HIV/AIDS, malaria and tuberculosis, as well as HIV co infections and
comorbidities such as cervical cancer and hepatitis C, and cross cutting issues, such as fever
management. Its catalytic projects aim to fill the gap between late stage development of heath
products and their widespread adoption, allowing countries and major funders to deliver more
with less.
The United Nations Entity for Gender Equality and the Empowerment of Women (UN Women)
Is the United Nations entity dedicated to gender equality and the empowerment of women. A
global champion for women and girls, UN Women was established to accelerate progress on
meeting their needs worldwide. UN Women supports UN Member States as they set global
standards for achieving gender equality and works with governments and civil society to design
laws, policies, programmes and services needed to ensure that the standards are effectively
implemented and truly benefit women and girls worldwide. It works globally to make the vision of
the Sustainable Development Goals a reality for women and girls and stands behind women's
equal participation in all aspects of life. UN Women also coordinates and promotes the UN
system's work on advancing gender equality in all deliberations and agreements linked to the
2030 Agenda. The entity works to position gender equality as fundamental to the Sustainable
Development Goals and a more inclusive world
The World Bank Group
Is one of the world's largest sources of funding and knowledge for developing countries. In line
with its global strategy for health, nutrition and population (HNP), the World Bank Group
supports countries* efforts to achieve universal health coverage and provide quality, affordable
health services to everyone-regardless of their ability to pay-reducing the financial risks
associated with ill health and increasing equity. The path to universal health coverage is specific
to each country. Whatever the path, the World Bank Group's aim is to help countries build
healthier, more equitable societies, as well as to improve their fiscal performance and country
competitiveness in order to build human capital, end poverty and boost shared prosperity. The
World Bank Group commits about US$3 billion annually in new funding for health; and is
currently managing an active NP portfolio of $16.7 billion by IBRD/IDA and over $1 billion in
trust funds.
The World Food Programme (WFP)
Is the leading humanitarian organization saving lives and changing lives, delivering food
assistance in emergencies and working with communities to improve nutrition and build
resilience. As the international community has committed to end hunger, achieve food security
and improved nutrition by 2030, one in nine people worldwide still do not have enough to eat.
Food and food-related assistance lie at the heart of the struggle to break the cycle of hunger
and poverty. WFP's efforts focus on emergency assistance, relief and rehabilitation,
development aid and special operations. Two thirds of its work is in confict affected countries
where people are three times more likely to be undernourished than those lungies countries
without conflict. Every year. WFP assists nearly 90 million people in more than 80 countries.
The World Health Organization (WHO
Provides global leadership in public health within the United Nations system. Founded in 1948,
WHO 20rks to promote health, keep the world safe and serve the vulnerable, Its goal is to
ensure ted from
2023, a billion more people have universal health coverage; a billion more people are protected
from health emergencies: and a further billion people achieve better health and wellbeing. WHO
hosts the Global Action Plan Secretariat.
The Global SDNM encompasses the four areas of education, jobs, leadership, and service
delivery. Each "strategic direction" comprises
EDUCATION
Strategic direction: Midwife and nurse graduates match or surpass health system demand and
have the requisite knowledge, competencies and attitudes to meet national health priorities.
Policy priority: Align the levels of nursing and midwifery education with optimized roles within the
health and academic systems.
Policy priority: Optimize the domestic production of midwives and nurses to meet or surpass
health system demand.
Policy priority: Design education programmes to be competency-based, apply effective learning
design, meet quality standards, and align with population health needs.
Policy priority: Ensure that faculty are properly trained in the best pedagogical methods and
technologies, with demonstrated clinical expertise in content areas.
LEADERSHIP
Strategic direction: Increase the proportion and authority of midwives and nurses in senior
health and academic positions and continually develop the next generation of nursing and
midwifery leaders.
Policy priority: Establish and strengthen senior leadership positions for nursing and midwifery
workforce governance and management and input into health policy.
Policy priority: Invest in leadership skills development for midwives and nurses.
JOBS
Strategic direction: Increase the avallability of health workers by sustainably creating nursing
and midwifery jobs, effectively recruiting and retaining midwives and nurses, and ethically
managing international mobility and migration.
Policy priority: Conduct nursing and midwifery workforces planning and forecasting through a
health labour market lens.
Policy priority: Ensure adequate demand (jobs) with respect to health service delivery for
primary health care and other population health priorities.
Policy priority: Reinforce implementation of the WHO Global Code of Practice on the
International Recruitment of Health Personnel.
Policy priority: Attract, recruit and retain midwives and nurses where they are most needed.
SERVICE DELIVERY
Strategic direction: Midwives and nurses work to the full extent of their education and training in
safe and supportive service delivery environments.
Policy priority: Review and strengthen professional regulatory systems and support capacity
building of regulators, where needed.
Policy priority: Adapt workplaces to enable midwives and nurses to maximally contribute to
service delivery in interdisciplinary health care teams.