Nursing and Midwifery in the History of the World Health Organization (1948–2017)

Overview

Since the founding of the World Health Organization (WHO) in 1948, nursing and midwifery development has maintained a distinguished status within the human resources for health programme of the Organization.

This report documents the progress made by using chronological and thematic approaches to chart the key historical timelines and events that have shaped the nursing and midwifery policy discourse through the decades. It also examines available strategic opportunities to build effective programmes that will ensure a socially responsible and fit-for-purpose nursing and midwifery workforce to meet the health needs of today and the future. The early years of nursing and midwifery within WHO witnessed a deliberate attempt by the Organization to establish, clarify and scale up the role of nurses and midwives in providing health care services in countries.

WHO established expert committees on nursing (and subsequently midwifery) to provide technical advice to WHO in addressing critical challenges affecting nursing and midwifery, such as the acute shortage of skilled nurses and midwives serving at the time, the need for training, better recruitment and employment standards. Other initiatives such as the WHO fellowship programme also helped to rapidly introduce and expand skilled nursing and midwifery services to individuals and communities in benefitting countries.

The multilateral adoption of the primary health care (PHC) approach by Member States in the 1970s resulted in marked changes to the organization and delivery of health care services at country level. Nurses and midwives consequentially assumed greater relevance for delivering PHC services given their relative abundance in many settings, as health planners aimed to achieve an appropriate mix of skills for the delivery of people-centred care. The overwhelming significance of PHC as pivotal for UHC triggered the need for greater support and led WHO to strengthen its collaborative activities with key nursing and midwifery professional associations and international NGOs.

WHO also established collaborating centres on nursing and midwifery at regional and global levels to assist with the provision of scientific norms and technical assistance to Member States. Establishing nursing and midwifery leadership at governance and service levels in countries has remained a major challenge to date. WHO continues to engage ministries of health, government chief nursing and midwifery officers and other relevant stakeholders and government bodies to enable effective planning, coordination and management of nursing and midwifery programmes in countries. More recently, WHO and Member States, through the Global Strategy on Human Resources for Health: Workforce 2030 and the Global Strategic Directions for Strengthening Nursing and Midwifery 2016–2020, aim to ensure the availability of quality, cost-effective and acceptable nursing and midwifery care based on population needs and in support of Universal Health Coverage (UHC) and the Sustainable Development Goals.

Additionally, ILO, OECD and WHO, through the five-year action plan of the United Nations High-Level Commission on Health Employment and Economic Growth, are promoting multi-stakeholder and intersectoral efforts to enhance women’s contribution to the nursing and midwifery health labour market.

Integrating and scaling these efforts will require greater political will, effective leadership and an enabling environment to ensure that nurses and midwives are adequately motivated and empowered to discharge their duties with better effectiveness and satisfaction.