Resolution of the World Health Assembly

RESOLUTION OF TilE WORLD IIEALTII ASSEMBLY

Forty-Fifth World Health Assembly Agenda Item 18 -

STRENGTHENING NURSING AND MIDWIFERY IN SUPPORT OF STRATEGIES FOR HEALTH FOR ALL

The Forty-fifth World Health Assembly, Having considered the Director-General's report on strengthening nursing and midwifery in support of strategies for health for all, and the discu ssions at the eighty-ninth session of the Executive Board; Recalling resolution WHA42 .27 ;

11 May 1992

where appropriate, in order to meet the changing health care needs of populations; • promote and support health services research that will ensure the optimal contribution of nursing and midwifery to health care delivery, with particular emphasis on primary health care; • ensure appropriate working co n d itio n s in order to sustain the motivation of personnel and improve the quality of services;

Mindful of the growing demand for and cost of health care in countries throughout the world;

• ensure the allocation of adequate resources (flnanclal , human and logistic) for nursing and midwifery activities;

Concerned at the continued shortage of nursing and midwifery personnel and the urgent need to recruit, retain, educate and motivate sufficient numbers to meet present and future community health needs;

• ensure that the contribution of nursing and midwifery is reflected in health policies;

Recognizing the need to increase the Organization's nursing an d rmdwifery activities at all level s; Committed to the promotion of nursing and midwifery as essential health services in all countries, for the development and improvement of health-for-all strategies ;

3 - REQUESTS WHO regional committees to reinforce regional actions in order to enable Member States to implement the above provisions effectively and to identify sources for financing such act ion s in those States which are undergoing economic structural reform programmes or which have other special needs; 4 . REQUESTS the Director-General to:

1. THANKS THE Director-General for his report;

2. URGES Member States to ; • identify their nursing and midwifery se rv ice needs and, in this context, assess the roles and utilization of nursing and midwifery personnel;

• establish a global multidisciplinary advisory group on nursing and midwifery, with the express purpose of advising the DirectorGeneral on all nursing and midwifery services and in particular on:

• s tre n g t h e n managerial an d le ad e rs h ip ca pa b ilities and reinforce the positions of nursing and midwifery personnel in all health care settings and at all levels of service, tncludlng the central and local services of health ministries and the local authorities responsible for the programmes concerned;

- developing mechanisms for assessing national nursing and midwifery se rvic e needs ;

• enact legislation, where necessary, or take other appropriate measures to ensure good nursing and midwifery services;

- monitoring progress in strengthening nursing and midwifery in support of strategies for health for all.

• strengthen education in nursing and midwifery, adapt educational programmes to the strategy for health for all, and revise them

• mobilize the increased technical and financial support required to implement the provisions of this resolution;

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assisting countries with the development of national action plans for nursing and midwifery services including research and resource planning;

SEPT EMB ER 1993

• strengthen the global network of WHO collaborating centres for nursing and midwifery in the implementation of health for all;

• ensure that the interests of nursing and midwifery services are taken into account in policy implementation and programme development, and that nursing and midwifery experts participate in WHO committees as appropriate;

• report on progress made in the implementation of this resolution to the Forty-ninth World Health Assembly.

WHO PRESS RELEASE NURSING AND MIDWIFERY: A FRESH LOOK

Concerned about the optimal contribution by nursing and midwifery in health care delivery in all Member States, the World Health Organization (WHO) is convening a meeting of the Global Advisory Group on Nursing and Midwifery in Geneva from 30 November to 2 December 1992. The Advisory Group was created as a result of discussions during the Forty-fifth World Health Assembly in May 1992 when it became clear that the overwhelming majority of WHO Member States were experiencing serious shortages of nurses and midwives. These findings led to the Assembly adopting a resolution calling for the strengthening ofnursing and midwifery in support ofstrategies for Health for Alland requesting the Director-General to establish a Global Advisory Group. In a recent study by WHO it was found that there are four major areas where professional nursing and midwifery skills are crucial to the provision of effective and efficient health care services:

Preventative care: Health promotion and disease prevention are an integral part of the work of nurses and midwives. In many countries they are the primary care-givers in communities, in particular to the most vulnerable populations, such as the urban poor, those in remote rural areas, mothers and children, the elderly, and the chronically ill. The profession plays a crucial role in reducing neonatal and maternal mortality as well as in preventing birthrelated complications. Curative care: As the front-line health workers in many countries, public health nurses diagnose and treat a wide range of common health problems. Globally, however, the majority of nurses work in hospitals where the need for care is growing. Advanced medical technology requires highly skilled nursing care crucial to the recovery of the patient. SEPTEMBER 1993

NOVEMBER 1992

Chronic and rehabilitative care: More and more, the nursing profession is seen as a facilitator enabling patients to participate actively in their own care and health development. It is of the utmost importance for the chronically ill and the elderly, who must learn new ways of self-care. Teaching and care are needed to ensure for them and their families an optimal quality of life. Nurses also playa major role in the area of mental health, which involves community work, caring for acutely disturbed patients, rehabilitation of the chronically mentally ill, and guidance or support to families.

Higb-dependency care and care of'tbe dying: Advances in medical science and technology have led to a growing number of severely physically and mentally impaired persons surviving for many years in a state of complete dependency. In a relatively recent development, the AIDS pandemic has dramatically increased the need for nursing care to the severely ill and the dying. Nursing and midwifery have evolved differently in different parts of the world in terms of both education and professional reponsibilities. In recent years the profession has become increasingly sophisticated and dynamic requiring a variety of highly developed skills. In some countries, nurses and midwives are often called upon to coordinate the care provided by physicians and other health professionals. They also train and supervise auxiliary health workers. They are engaged in policy decisions. Despite these expanded functions, the popular image of the nurse is still that of a uniformed hospital worker caring for physically ill patients in a role that is not seen as central or therapeutic in its own right. The public at large is often unaware that nurses and midwives are actively engaged in public health policy. ACMIJOURNAL

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