Vital roles of nurses and midwives

The Western Pacific Region (WPRO) is one of the six regions of the World Health Organization (WHO), where approximately 1.8 billion people reside in 37 partner and member states that are diverse in many aspects: economically, geographically, culturally, as well as climatologically [1]. The WPRO includes embeds some of the world's least developed countries as well as the most rapidly emerging economies [1]. Some countries in WPRO are marked with increasing populations and others that are rapidly ageing. Health systems are well developed in some countries and vulnerable in others. It is the most disaster-prone region in the world, it embraces emerging infectious disease threats, non-communicable disease (NCD) epidemics, ageing populations, and rising health service costs, and large-scale adversities threaten the psychological, social and physical well-being of the communities in the WPRO and overwhelm its monetary and human resources [1].

The WHO estimated SDG threshold density of 4.45 health workers per 1000 population is difficult to assess and apply in some parts of the Region where small island states with small and widely dispersed populations that create challenging labour market conditions [2]. Globally, it is estimated that the current shortage of nurses and midwives is 9 million, with the Western Pacific accounting for nearly 30% of this shortage [3].

This program of work was initiated by the WHO WPRO to document the country-level experiences and the vital roles of nurses and midwives to raise awareness amongst the population, government and other decision –makers regarding the contributions that nurses and midwives are making to achieve the regional White Paper thematic priority areas, WHO 13th Global Programme of Work (GPW13) and the Sustainable Development Goals (SDGs).

This Vital Role of Nurses and Midwives Report coincides with the year 2020 that has been highlighted by WHO as the International Year of the Nurse and the Midwife that is highly significant for these professions, and their role in achieving universal health coverage (UHC) [4]. WHO is leading the development of the first-ever State of the World’s Nursing (SOWN) Report that will be published and launched in 2020, prior to the 73rd World Health Assembly. The SOWN report will provide further data and evidence for the case of where to invest in nursing.

The case studies document real-life examples of work being carried out by nurses and midwives in the Western Pacific region. They highlight the importance and critical nature of the work undertaken by these professions in this diverse region to meet the evolving challenges to provide quality health care to their communities.

Discussions and interviews were held with well over 150 nurses, midwives and other health professionals across the majority of countries in the Region throughout 2019. While it was not possible to include all the case studies here, those included provide insight into a cross section of the range of roles in countries across the Region highlighting the unique variety of challenges that nurses and midwives face every day. These case studies attempt to reflect the Western Pacific’s unique economic, social and environmental context.

The case studies are categorized into the four thematic priority areas from the WHO WPRO White Paper as follows: