Universal Health Coverage on the Agenda in 2023

The World Health Organization (WHO) Executive Board met recently from January 30 to February 7 in Geneva. A major theme this year is Universal Health Coverage (UHC) in preparation for the UN High-Level Meeting on UHC in September 2023. The previous High-Level Meeting on UHC in 2019 resulted in a commitment “to ensuring that, by 2030, everyone, everywhere will be able to receive quality health services without suffering financial hardship.” Further, UHC “covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.” (WHO 2022).

Courtesy of UHC Coalition

There is an important connection between primary health care and sustaining the workforce to achieve the goal of UHC. I like the way it was expressed by the United Nations Foundation following the Executive Board meetings:

“Member States emphasized that stronger primary health care delivery and a robust health workforce were force multipliers that could jointly serve UHC and pandemic preparedness, response, and resilience goals and the Sustainable Development Goals writ large.” (UN Foundation 2023).

WHO’s Executive Board meeting sets the tone for a big year in global health (unfoundation.org)

The International Council of Nurses (ICN) delivered statements at the Executive Board meetings as part of civil society coalitions urging Member States to commit to investing in the health workforce for UHC. Themes of equity, patient advocacy, emergency preparedness & response and quality of care came through in the statements. A summary of ICN interventions on health care issues during this Executive Board session is worth reading to see the topics covered.

In keeping with the strong global health presence of ICN and its national nursing association members, the next ICN Congress holds promise for discussion of global policy directions. The ICN Congress co-hosted by the Canadian Nurses Association is taking place in Montreal from July 1-5. I have enjoyed participating in past congresses and look forward to attending this one on Canadian soil. The theme – Nurses Together: A Force for Global Health – provides optimism amidst troubling times for the profession and the world. I expect to hear perspectives on current global health challenges and examples of solutions to common issues: nursing retention, Sustainable Development Goals and contributions to achieving UHC. There will be symposia profiling national nursing associations and their activities, plenary sessions, a student assembly, posters and concurrent presentations.

Another feature is the Policy Cafés – highly informative and interactive as I observed in Singapore in 2019. For this congress ICN describes them as: “Located in the exhibition hall, the two Cafés give the opportunity for small group discussion with a panel of experts on a key ICN policy or priority topic. Arranged in an informal setting, the Cafés allow delegates to ask in-depth questions and interact with keynote speakers.” For registration and further details, please visit the ICN Congress Site and follow updates on social media.

By Nora Whyte – February 22, 2023

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Resources

UHC 2030 Coalition: Taking Action for Universal Health Coverage.

UHC 2023 Coalition: Universal Health Coverage Message Sheet for 2023.

World Health Organization (2022). Fact Sheet on Universal Health Coverage.

Sustaining the Canadian Health Care Workforce

As I write this reflection in late autumn 2022, the topic of the Canadian nursing workforce is on my mind. In the context of my consulting work I am often engaged in discussions on recruitment and retention of nurses in Indigenous communities. We look for ideas from many sources and consider strategies that will be most effective in the local context on Vancouver Island.

National organizations have issued statements and reports this month that highlight the urgency of human resources in the Canadian health system. In conjunction with a meeting of provincial and territorial ministers of health with the federal health minister, many organizations held meetings and issued briefing notes. The Canadian Medical Association (CMA), Canadian Nurses Association (CNA) and HealthCareCAN issued a “prescription for hope” that received media attention at that time. A follow-up letter to the Council of the Federation Chair of was issued on November 22 by the Canadian Federation of Nurses Unions (CFNU), CNA and CMA requesting an “urgent meeting” on finding solutions the health care crisis. I follow all these organizations on social media and appreciate seeing frequent updates and timely media releases. The media release and link to the letter are available here: Nurses and doctors engage Council of the Federation around solutions to Canada’s health crisis (cna-aiic.ca)

On November 17, the Canadian Health Workforce Network and the CFNU released a comprehensive report: Sustaining Nursing in Canada. I recommend working your way through the entire document when time permits as I’m doing at present. For a quick overview, I suggest the “Strategic Priority Actions” on page 9 followed by the Executive Summary. The “multi-layered solutions” offered are most welcome. We do need to think of steps and layers in a coordinated way and not a piecemeal approach. See also page 23 for a figure summarizing key points around retaining, returning and recruiting nurses.

Workforce planning is a strong theme of Sustaining Nursing in Canada with three steps identified on page 14: 1) Embed nursing workforce planning, 2) Enhance nursing data to support inter-professional workforce planning and 3) Enable nursing workforce partners access to evidence. In terms of priority actions, some are directed at employers and governments. I see a cluster of proposed actions that would help in nursing education and in mentoring students and new graduates as well as attention to supporting nurses over the course of a career. It’s intriguing to consider the idea of the national health workforce agency (pages 52-53) and I think that we may hear more about implementing something similar in Canada.

It is both a worrying and hopeful time as we reflect on media stories and personal experiences. I do hope that governments are paying attention at long last and that we will see solutions become a reality.

I end this post with images from earlier this fall when I visited the beautiful provinces of Nova Scotia and Newfoundland. I carry these memories with me with optimism for improvements in health care for people and communities in all parts of our country.

Peggy’s Cove Village, Nova Scotia
Government House Garden St. John’s, NL

By Nora Whyte – November 25, 2022

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

Updates on Nursing Associations 2022

Parksville, BC – June 2022

I’m writing this update at the end of June in advance of our summer break in Canada. World events in the first half of 2022 have left us shaken and concerned about the future as we grapple with climate issues, global conflicts, food security, and population health. As I follow the daily news, I also turn my attention to developments in nursing and look for statements and opportunities for advocacy.

ICN Updates

The 75th World Health Assembly took place in May. It was interesting to follow on social media as it generated considerable attention this year. The International Council of Nurses (ICN) was active in presenting ‘Interventions’ on specific resolutions. See ICN’s summary here.

ICN along with the International Confederation of Midwives and the WHO met for their 9th Triad meeting in May. The representatives issued the 2022 Triad Statement focusing on health care workforce issues and reporting on what countries are doing in response to the Global Strategic Directions for Nursing and Midwifery 2021-2025. Howard Catton, ICN CEO, has been interviewed by many news media this year speaking about the war in Ukraine and related humanitarian crises and on the scale of the nursing shortfall globally.

Annual Meetings

The Canadian Nurses Association (CNA) and the Association of Nurses and Nurse Practitioners of BC (NNPBC) held their annual meetings in June. Both were open to all members and observers in a virtual format. The CNA Meeting of Members was noteworthy because it marked the first time that individual members could vote to elect candidates for the Board of Directors and vote on AGM motions. The previous federation model of territorial and provincial member associations carrying votes has ended. As a member who is following these changes, it will be interesting to see how the new membership structure will work and how the new Board will communicate with members throughout the country.  

After both meetings, I was left somewhat disappointed that there wasn’t more substance presented on what our associations are doing to demonstrate leadership during the current health care staffing crisis and other major issues in 2022 (I receive newsletters and view social media updates but others may not). I do recognize that annual meetings present highlights and financial statements on the previous year and are always six months out of date for the current year’s activities. It makes me wonder if members would be interested in (and commit to attending) an organizational update given in the autumn each year. We could meet the new Board members, hear their priorities for the current year, and ask questions – all through a virtual format, and in a less formal manner than at an annual meeting.

Annual meetings and major events aside, I do appreciate the ongoing work of our professional associations at all levels to bring a nursing perspective to provincial, national, and global health challenges and policy change.

By Nora Whyte – June 27, 2022

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

Save the date for July 2023!

The Privilege of Membership

This is the time of year when membership fees are due and the reminders start rolling in. It is a time when I consider whether or not to renew my membership in various organizations and what commitments I’ll make in the year ahead. In particular at the start of 2021, I have been thinking about the privilege of membership in the Canadian Nurses Association.

As noted on its website, the Canadian Nurses Association (CNA) is “the national and global voice of Canadian nursing, working with nurses in all 13 jurisdictions across Canada to bring essential and meaningful change to health care and nursing in the country.” Membership is open to all regulated nurses who may join as individuals or through their membership in provincial and territorial associations in jurisdictions that are CNA members. Major changes in jurisdictional nursing organizations across Canada will continue to have an impact on national membership. For the first time, I will be taking out an individual membership because the annual membership fee in my provincial association, the Nurses and Nurse Practitioners of British Columbia (NNPBC), no longer includes CNA membership. I remain supportive of NNPBC and CNA and hope that we’ll see new membership models and fee structures in the coming years. Membership in CNA is a vital link to our dynamic global nursing body, the International Council of Nurses.

During the summer and fall of 2020, CNA conducted a member survey to build on dialogue and engagement sessions conducted in 2019 & 2020. For a good overview of survey results, see Your Voice, Your Association.  

Survey respondents viewed CNA in a favourable way with 81% noting that a national professional association is essential.  Communication is key to engagement and three preferred methods are: direct email, social media & webinars. Ideas for building a strong and effective association include:

  • Engage with membership on a grassroots level
  • Offer more mental health resources
  • Offer more continuing education opportunities
  • Forge strong partnerships with provincial and territorial associations

Highlights of the past year – shaped so dramatically and sadly by the pandemic – were linked to my longtime interest in professional associations and their role in policy advocacy clearly in evidence during 2020. It was satisfying to be a co-author with stellar colleagues, Patrick Chiu and Susan Duncan, on an article published in the Canadian Journal of Nursing Research:  

Charting a Research Agenda for the Advancement of Nursing Organizations’ Influence on Health Systems and Policy – Patrick Chiu, Susan Duncan, Nora Whyte, 2020 (sagepub.com)

In our abstract we indicate how we drew on “recent key national and global events including our systematic inquiry into Canada’s 2019 federal election, the Year of the Nurse and Midwife, and the Coronavirus pandemic to examine how Canadian nursing organizations respond in highly complex and evolving contexts.” Further, we used our observations to offer a vision and chart a research agenda for the advancement of nursing organizations’ influence on health systems and policy.

Another highlight that took place at the end of 2020 was receiving a Lifetime Achievement Award from NNPBC at a wonderful virtual 2020 Nursing Awards of Excellence Ceremony featuring music, dance, videos, and special messages from CNA and others. It was an emotional and proud moment to be among the group of BC nurses recognized for contributions to the profession in our province.  

Award from NNPBC – December 2020

I look forward to staying connected to nursing’s collective presence and voice provincially, nationally, and globally in 2021.

By Nora Whyte – January 19, 2021

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

Postscript: February 21, 2021

For nurses from BC, the process of membership renewal in CNA was delayed at the start of this year. I was unable to renew in January as planned. Glad to see that the membership portal is working now and that we can renew or rejoin as BC registrants or retired members. Annual membership gives us access to the Canadian Nurse and opportunities to participate in our national association and the ICN. In fact, to submit an abstract (as first author) for the ICN Congress in November, one must belong to a National Nursing Association. I’m thankful that CNA is a member of ICN and that’s one of my primary reasons for renewing my CNA membership.