At the launch of the Strategic Directions for Nursing in the Region of the Americas, the Pan American Health Organization (PAHO) called on countries to invest in nurses to improve their availability, distribution and roles in order to advance towards universal health. Nursing staff represent the largest health workforce, accounting for more than 50% of health workers. Despite this, the lack of nurses in most countries in the region compromises the global goal of achieving health for all by 2030. Dr. Carissa F. Etienne, Director of PAHO, highlighted, “In many parts of the world, nursing professionals are the first, and sometimes only, human resource in contact with patients,” and she claims that “investing in nursing enables advancing towards access and universal health coverage, which will have a profound effect on global health and well-being”.
Gap in availability and access to human resources
The report on strategic direction describes the current situation regarding nursing in the region. It highlights that there is an important gap in the availability of and access to human resources for health, of which nurses are an important part. As well as this, there is also a current deficit of 800,000 health workers in the region, including nursing staff.
Mobility and migration, poor distribution, lack of regulation, insufficient incentives and professional advancement, lack of higher education, and inadequate working environments all increase the problems related to human resources for health all over the world.
To address the migration of nursing personnel, the report considers it necessary to invest in human resource retention strategies, particularly in low-income countries and small island developing states.
Low nurse to inhabitant ratio
The density of nursing staff, which includes licensed nurses, technicians and assistants, varies from country to country, and is generally low in the region. Therefore, while in the United States and Canada, there are more than 111 and 106 nurses per 10,000 inhabitants respectively, in Haiti, Honduras and the Dominican Republic, there are less than 4.
There are also discrepancies in the number of nurses per doctor. In the United States and Canada, there are 4 nurses per doctor. However, in the other 27 countries analyzed, there are less than 2, and 15 of them have less than 1.
According to the report, avoiding a deficit of nursing professionals requires the development of national strategies for the training of new professionals, as well as adequate retention policies, investment in the workforce and promotion of professional autonomy.
“Only with an adequate number of motivated and well-distributed professionals with technical and scientific skills, will countries be able to achieve universal health coverage and access, as well as the SDGs,” said Silvia Cassiani, Regional Advisor on nursing and health technicians at PAHO, Regional officer for the Americas of the World Health Organization.
Recommendations
The report also recommends expanding and regulating the role of licensed nurses in the first level of care to improve access and care in areas with a limited number of physicians. The report also advocates for the better distribution of personnel in remote and rural areas; an increase in incentives for interprofessional practice, and an increase in the number of accredited training programs, particularly given that in most countries, there are few nursing schools and graduate programs.
The report, which is presented in the framework of the International Day of Nursing, is the product of an extensive consultation process and evidence analysis. It also addresses issues such as leadership, working conditions and the capacities, educative and distribution of personnel.
