Dean Holzemer

The Dean’s Desk | Thoughts from Rutgers Nursing Leadership

WHO Fails to Understand the Need For Nursing Education Resources

Thursday, November 3, 2016

William L. Holzemer, RN, PhD, FAAN
Rutgers University School of Nursing

In an earlier entry on this blog, I wrote about my two-week excursion to South Africa this summer for the International AIDS Society’s global AIDS conference in Durban. In conjunction with that event, the Rutgers School of Nursing co-hosted a preconference on nursing’s contributions on the HIV/AIDS front, along with the Association of Nurses in AIDS Care and the International Council of Nurses

Our nursing-focused session included a lengthy discussion of the World Health Organization’s recent publication, Global Strategic Directions for Strengthening Nursing and Midwifery Services - 2016-2020. Unfortunately, I see no real concrete plans or objectives in this document that would expand the nursing workforce and its ability to address the U.N. Sustainable Development Goals (SDGs).  Once again, WHO is supporting suppression of nursing education, failing to recognize nursing’s importance to global health.

One WHO objective is, “To educate, recruit, deploy and retain the right number of nursing and midwifery workforce with appropriate competencies, equipped with the necessary resources and governed by professional regulation.” The group further proposes to “Align investments and coordinate plans for development of nursing and midwifery in workforce management; in pre- and in-service education; in regulation; and in guaranteeing positive practice environments.” 

Historically, WHO supported in-service education to a poorly trained, discouraged, inadequate nursing and midwifery workforce that included staff nurses, administrators and faculty.  Very few resources have historically been directed toward pre-service education to enhance the quality of education available to train nurses and sustain competency of nursing faculty. 

Perhaps this call that includes “pre-service” education is a promising sign – but since I have visited schools of nursing in Tanzania that had one desk, outdated text books, no technology only a few years ago, I am not too encouraged.  The proof will be if WHO can actually convince its members, i.e. Ministers of Health, to work with Ministers of Education to improve the resources, quality, and capacity of nursing and midwifery programs to prepare qualified nurses to contribute to meeting the SDGs.  

While very significant shortages of resources exist in the educational settings in many countries, inadequate staffing is also a significant challenge for nurses. Can the Ministers of Health address that inadequate staffing in many rural health clinics where one nurse/midwife works alone with few resources and almost no mentorship or support?

I returned from South Africa invigorated by the potential for nurses – especially Rutgers-trained nurses – to play an even larger role in high-quality healthcare, especially as the battle against HIV/AIDS, Malaria, and TB and also primary care.  But as you can see, I remain concerned that some leading public health policy advocates do not fully understand the critical contributions that nurses can make, and consequently resources remain totally inadequate for the challenge ahead.


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