Revisiting Primary Health Care in 2018

Achill Island, Mayo, Ireland

This summer began early for me with a holiday in Ireland for a wonderful family wedding in Donegal and a chance to visit the beautiful West of Ireland full of stunning scenery, quiet byways and national parks. It was a memorable time exploring the coastal countryside at a leisurely pace and enjoying Irish hospitality along the way.

International travel is a great opportunity to gain perspectives on the world and to reflect on current events in different contexts. At home in Canada, I follow developments in both national and global health policy and politics.

Global health is in the spotlight this year with the 40th anniversary of the Alma-Ata Declaration on Primary Health Care (PHC). The philosophy and approach of PHC guided governments in many countries during the past four decades. To mark this anniversary, the Global Conference on Primary Health Care will be held in Astana, Kazakhstan this October co-sponsored by the World Health Organization, UNICEF and the Government of Kazakhstan.

In revisiting PHC in the current era, the conference will make the link to the Universal Health Coverage (UHC) movement and the Sustainable Health Goals. It will be fascinating to follow the event on social media and to read the final declaration. The draft version has been circulated for comment and will undergo changes before endorsement by conference participants. I like the attention to political will, knowledge for health systems improvement, effective use of technology and greater social accountability. There is recognition of the role of youth in contributing to PHC achievement and attention to equity and determinants of health. I wonder if the notion of political will has gone far enough and how this will be handled in a high-level global assembly.

Critical perspectives are coming forward in response to the proposed declaration. The organization Women in Global Health has pointed out the declaration’s failure to note the importance of gender equality in achieving UHC and PHC. As highlighted in its statement, “effective health systems must ensure gender parity at all levels of decision making to harness women’s perspectives and talent.”

Nursing Now and the International Council of Nurses have issued a joint statement on the draft declaration. A key point is recognition of the “central role” of nurses and midwives in PHC. The joint statement concludes with a strong endorsement:

We strongly agree that political will and sustainable financial resources will be vital to delivering the ambitions of the Astana Declaration. Insufficient investment, the lack of long term planning and political commitment in health services and the workforce continues to be a major impediment to progress. We resolutely support a declaration that will deliver change and achieve UHC through PHC.

My own conclusion is that this is an exciting time for global health with renewed energy in the PHC movement and opportunities for critical commentary in the months leading up to the Global Conference on Primary Health Care. This is most definitely a time to stay tuned!

By Nora Whyte – August 2, 2018

Nursing Now: Campaign for Nursing & Global Health

Nursing Now is a three-year campaign to raise the profile of nursing globally and to enhance the profession’s contribution to people’s health and health systems. In partnership with the International Council of Nurses (ICN), the Burdett Trust in the UK, World Health Organization and others, Nursing Now has described the campaign goals to be achieved by the end of 2020:

  • Greater investment in improving education professional development, standards, regulation and employment conditions for nurses;
  • Increased and improved dissemination of effective and innovative practice in nursing;
  • Greater influence for nurses and midwives on global and national health policy;
  • More nurses in leadership positions and more opportunities for development at all levels; and
  • More evidence for policy and decision makers about where nursing can have the greatest impact, what is stopping nurses from reaching their full potential and how to address these obstacles.

The campaign launch at the end of February 2018 received an enthusiastic response as events were held in various locations and promoted widely through social media. Having first heard about early ideas for Nursing Now during the ICN Congress in Barcelona (May 2017), I have been following developments with great interest and will continue to do so during the three-year campaign. I was pleased to read an overview of the campaign in the March-April issue of the Canadian Nurse including a profile of Sarah Walji who represents young nurses on the Nursing Now campaign board.

Nursing Now will look for opportunities for policy influence through presenting ideas to special commissions and participating in global health events. An initial opportunity this year is the High-level Commission on Non-Communicable Diseases. The Nursing Now team has been seeking input from nurses in preparing a brief to showcase nursing’s role in promoting health and preventing disease.

What now? Suggestions for involvement include pledging support, joining or setting up a national group, providing case studies and contributing to social media discussions. As a first step, nurses can sign up to receive regular updates.

The campaign has great potential to raise the profile of global and national nursing organizations including the ICN and its member national associations. It will be interesting to track achievements during the next three years to observe its impact and to learn about the most effective strategies for realizing the desired changes. It will be important also to consider any issues or concerns arising from this major initiative. It may be that all the focus on nursing is viewed negatively by other professions and there could be challenges embarking on the campaign in countries where governments have limited interest in a strong health sector. It will be important in all aspects of this initiative to refrain from being inward-looking as the nursing profession increases its collective capacity and policy presence for global health.

Follow on Twitter: @NursingNow2020

Posted by Nora Whyte –  April 29, 2018


Human Resources for Health: Highlights from Fourth Global Forum

ForumLogo-Option3-1During the past few months I have followed several national and global conferences and events. One that caught my interest was the Fourth Global Forum on Human Resources for Health held in Dublin in November 2017. Although I could not attend in person, I did enjoy the live streaming of sessions and the social media interaction on the theme – Building the Health Workforce of the Future. The forum concluded with the Dublin Declaration on Human Resources for Health and a Youth Call for Action.

As an observer from afar it was interesting to listen to some of the plenary sessions and to learn about organizations collaborating on this strategic agenda including the Global Health Workforce Network. There is an increasing recognition of the benefits of investing in a well-educated, supported health workforce, both in terms of a nation’s economic growth and health system development.

The Youth Call for Action is noteworthy because it marked the first time that students and young health professionals have met in an organized Youth Forum attached to the Human Resources for Health Forum. Key messages from their participation in the forum include:

  • Youth are an essential agent of change in the world;
  • Youth are an asset for achieving the 2030 agenda on sustainable development;
  • A need for country-level action on decent jobs for youth in health and social sectors;
  • Create opportunities for youth to participate in global meetings; and
  • Call upon the World Health Organization to establish a WHO Hub on Youth within the Global Health Workforce Network.

The president of the International Council of Nurses, Annette Kennedy, was a speaker at the closing plenary. She pledged support from ICN for implementing the Dublin Declaration and welcomed the “collective political commitment demonstrated at the Forum.” She highlighted ICN initiatives to contribute to the Sustainable Development Goals and Universal Health Coverage – see the November 21, 2017 media release from ICN for details.

Posted by Nora Whyte – December 11, 2017.

Nursing Now! Campaign to Launch in 2018

In my June 28 post on the 2017 International Council of Nurses Congress, I referred to a presentation on the Triple Impact Report of the UK’s All-Party Parliamentary Group on Global Health.  During the Congress, Lord Nigel Crisp and Dr. Frances Hughes offered an exciting preview of a global campaign arising from the report’s recommendations.

The Nursing Now! Campaign is being developed in the coming months – it will be interesting to follow as plans take shape for key strategies and partnerships. As noted in an August Update, the campaign’s goal is “to raise the status and profile of nursing globally so that it can make an ever greater contribution to health and well-being.” Details of proposed objectives and organizational partners are found in the August Update issued by the All-Party Parliamentary Group on Global Health. The campaign’s intent is to increase the capacity of nursing to influence policy and to focus on nurse leadership at local, national and global levels.

Stay tuned for updates in advance of the formal launch scheduled for early in 2018.

ICN 2017 Congress Report by Nora Whyte

What a pleasure it was to be among 8,200 nurses from 135 countries who participated in the International Council of Nurses 2017 Congress in Barcelona in May! Hosted by the Spanish General Council of Nursing, this congress with its timely theme – Nurses at the Forefront Transforming Care – lived up to all expectations with stimulating plenary speakers, concurrent sessions and highly engaged nurses from around the globe.

ICN Congress Welcome

ICN Congress Welcome

The United Nations Sustainable Development Goals (SDGs) served as a guiding framework with emphasis on nurses as key to achieving the goals. Plenary presentations had a common theme of policy advocacy for health system change and sessions provided informative examples of national nursing associations contributing to positive change in their countries.

Plenary speakers included Dr. Linda Aiken and Dr. Mary Wakefield from the US, Dr. Julia Duncan-Cassell from Liberia and Lord Nigel Crisp from the UK. In her keynote on Safe Staffing to Transform Care, Linda Aiken presented highlights from her research in 30 countries to show how evidence-based staffing make a difference to patient outcomes. Each 10% decrease in the proportion of RNs in hospitals is associated with a 12% increase in risk of mortality. She noted that there is “plenty of evidence to convince governments to invest in nursing” but that safe staffing remains an issue.

Lord Nigel Crisp of the UK House of Lords and chair of the All-Party Parliamentary Group on Global Health (APPG) spoke about the work of the APPG in developing its 2016 Triple Impact Report:

Increasing the number of nurses, and developing nursing so that nurses can achieve their potential, will also have a wider triple impact of improving health, promoting gender equality and supporting economic growth (APPG, p.3).

Student Volunteers at ICN Congress. Photo credit: ICN

Student Volunteers at ICN Congress. Photo credit: ICN

The presence of nursing students during the congress was impressive: Spanish students were active as volunteers and other students brought their perspectives to sessions where they asked great questions. It was exciting to hear about the inaugural meeting of the Global Association of Student and Novice Nurses held in conjunction with the congress.

Informal Networking Outside Barcelona International Conference Centre

Informal Networking Outside Barcelona International Conference Centre

On a personal level, it was particularly meaningful to meet nurse leaders from around the globe including some members of the ICN Board of Directors. There were messages of thanks to outgoing president Judith Shamian and words of welcome to the incoming Board of Directors and new president Annette Kennedy who brings great experience and enthusiasm to her new role. ICN presidents have a tradition of selecting a “watchword” to guide their term – Annette Kennedy announced her watchword Together as highlighted in this excerpt from her acceptance speech:

Together we can ensure that we have a voice at every committee and policy table related to health care. Together we can encourage investment in primary care, health promotion and disease prevention and together we can provide that care. Together we can convince the public and policy makers that investing in health is an investment in our people and our economy. Together we can seek better working conditions for all nurses. Together we can realise our collective potential to make the world a healthier place for everyone. (ICN Press Information, June 2, 2017).

Looking to the future, ICN’s Voice to Lead campaign launched for International Nurses Day this year, will continue as a dynamic resource as ICN strengthens its social media and furthers its work on the SDGs.

The entire congress experience – with opportunities for stimulating exchange of ideas and  meeting nurses from many countries – was worthwhile in every way. To cap it off, I enjoyed extra days exploring the beautiful city of Barcelona!

Evening view of Barcelona - May 2017

Evening view of Barcelona – May 2017


Community Health: Action for Change

banner0-1The International Collaboration for Community Health Nursing Research has announced the call for abstracts for its 7th International Conference. The themes are:

Innovation & new trends in community health
Community involvement – best practices
Community nurses – skills development; redefining roles for new
Health policy – challenges & impact
National & international collaboration & partnerships in community
Research for the future

The conference takes place in September 2017 and the abstract deadline is May 30.

It’s exciting to see that this event is being held in Johannesburg where I lived and worked for three years.

Nora Whyte

Health Systems Global: Vancouver Statement


The Fourth Global Symposium on Health Systems Research wrapped up on November 18, 2016 (see previous post below dated November 15).  It was interesting to follow some of the live coverage and social media commentary during the event. The organizers issued a statement at the conclusion of the Symposium to highlight key reflections on the deliberations and to outline proposed actions. The Vancouver Statement builds on achievements and changing contexts since the Third Global Symposium held in Cape Town in 2014. The changes include adoption of the Sustainable Development Goals, increased attention to Universal Health Coverage and a greater recognition of the role of communities in shaping health policy.

For background on Health Systems Global and current activities, see the Health Systems Global Website.


Global symposium on health systems research


The fourth global symposium on health systems research is underway in Vancouver this week: November 14-18. There is live coverage and access to e-posters as well as other content throughout the week.

Participants are exploring the timely theme of ‘resilient and responsive health systems for a changing world’ as they meet in person and engage through social media.

Key points on the meaning of the theme are highlighted here:


International Council of Nurses 2017 Congress

The International Council of Nurses (ICN) will hold its next quadrennial congress in Barcelona, Spain from May 27 to June 1, 2017.

The congress theme of nurses at the forefront transforming care will feature sessions on the United Nations Sustainable Development Goals and papers grouped by themes including equity/ethics/human rights; health promotion and disease prevention; information and communication technology; nursing education and learning; regulation; and history. The congress will also provide opportunities for network meetings, a student assembly and meetings of the ICN member organizations known as the Council of National Nursing Association Representatives (CNR).


Student Assembly at 2013 ICN Congress in Australia.

Student Assembly at 2013 ICN Congress in Australia.


ICN has outlined three main objectives of the Congress:

  1. To demonstrate and advance the nursing contribution to informed and sustainable health policies;
  2. To support nursing’s contribution to evidence-based healthcare and to encourage problem-solving approaches to health priority needs; and
  3. To provide opportunities for an in-depth exchange of experience and expertise within and beyond the international nursing community.

Note: The abstract deadline is October 10, 2016.

Posted by Nora Whyte

World Health Organization’s Strategic Directions on the Global Health Workforce

World Health Assembly 2016. Photo credit: WHO/L. Cipriani

World Health Assembly 2016.
Photo credit: WHO/L. Cipriani


Two important policy documents were adopted by the 69th World Health Assembly in May 2016:

Both strategic frameworks provide direction on the global health workforce in support of achieving universal health coverage by overcoming gaps in availability, access and education.  The Workforce 2030 document provides context on the United Nations Sustainable Development Goals and the push to universal health coverage outlining milestones for 2020 and 2030. I have been reviewing the nursing and midwifery document with great interest as I reflect on its relevance to my work as a nursing consultant. The document is well organized in its presentation of four themes and guiding principles followed by an implementation section on proposed action and indicators for monitoring and evaluation. The thematic areas are:

  1. Ensuring an educated, competent and motivated nursing and midwifery workforce within effective and responsive health systems at all levels and in different settings.
  2. Optimizing policy development, effective leadership, management and governance.
  3. Working together to maximize the capacities and potentials of nurses and midwives through intra- and interprofessional collaborative partnerships, education and continuing professional development.
  4. Mobilizing political will to invest in building effective evidence-based nursing and midwifery workforce development (WHO, 2016, p. 14).

In reading the elaboration on each theme, I am pleased to note attention to positive work environments, recognition of the value of investing in education and professional development and discussion of leadership and advocacy for responsive health systems. Further, the document highlights the importance of engaging professional associations of nurses and midwives in policy development.

Although the document is intended primarily for the WHO system, including its regional offices and member countries, there is scope for the contributions of civil society partners such as nursing and midwifery professional associations and regulatory bodies. In proposing action on each of the four themes, the WHO identifies strategic interventions at the national, regional and global levels as well as a role for partner organizations. One such partner is the International Council of Nurses (ICN), a contributor to consultation sessions in development of the document and an advocate for collaborative efforts to improve global health. For those interested in further background reading, ICN maintains a collection of resources on health workforce developments.

This topic will be highlighted during the next ICN Congress will take place in Barcelona from May 27 to June 1, 2017. The Congress Website has preliminary information and detailed instructions for submitting online abstracts until October 10, 2016. The Congress theme – Nurses at the forefront transforming care – has been chosen to tie in with universal health coverage, strengthening the health workforce and the Sustainable Development Goals.

Posted by Nora Whyte

June 1, 2016