GAPFON Strategies and Principles

Strategies

As part of the GAPFON Summary Report, the following strategies were identified to advance global health and strengthen professional roles. These strategies are actionable at either the local, regional, or global level.  

Education

  • Advocate for reform of educational programs to support transformative, innovative, and interprofessional education for nurses, midwives, and all health professions.              
  • Develop a strategy to support and promote clinicians who wish to teach nursing and midwifery students in higher education (basic education and above).
  • Broaden midwifery training to include comprehensive women’s healthcare (in addition to pregnancy, delivery, birth control).              
  • Ensure accreditation of nursing and midwifery education programs.     
  • Raise awareness of existing minimum global standards for nursing and midwifery education, and provide guidance on how to adopt and adapt them within and across countries. 
  • Identify and develop a policy course model for nurses and midwives, appropriate to different levels of education.               
  • Advocate for and promote opportunities for nurses and midwives in all countries to engage in higher education, continuing education, and specialization in ways that meet their country’s and region’s health priorities.
  • Develop education for interdisciplinary and collaborative work in communities and healthcare settings.
  • Develop nursing specialization and advanced practice addressing the health priorities (beyond basic level).       
  • Work collaboratively to set uniform nursing and midwifery standards for education and practice in each region.

Leadership

  • Lead coalitions to address equity and health issues.     
  • Develop a multipronged leadership-development system with aspects of mentoring, coaching, and modeling to advance global health and the nursing and midwifery professions.         
  • Take a leadership role in using technology and state-of-the-art communications (social media, public service announcements, advertising campaigns, etc.) to engage and educate communities on public health issues and solutions—e.g., immunizations, nutrition, handwashing, prenatal care, services for addictions and mental health. 
  • Create collaborative networks of and among nurses, midwives, and organizations to focus on health issues and improve education, practice, and standards.  
  • Position nurses and midwives as a credible first point of contact for the media and public relations outlets.        
  • Rebrand and re-envision nurses and midwives as innovators in the healthcare profession.
  • Position nurses and midwives as critical partners in conversations related to national, regional, and global health.

Policy/Regulation

  • Create and implement an evidence-based policy agenda.  
  • Create a coalition to develop, lead, and influence policy around health inequities.
  • Work jointly within and across regions for a collective voice on the expansion of nursing and midwifery practice to improve universal access to care.   
  • Place nurses and midwives at the policy table to strengthen their impact on health policy and healthcare management.  
  • Invest in creative care enterprises led and managed by nurses and midwives that strengthen health systems.   
  • Lobby governments and NGOs to create and implement nursing and midwifery leadership programs to prepare a cadre of leaders who can contribute to healthcare at the highest levels.        
  • Provide formal policy and leadership training for all country-level chief nursing officers.
  • Promote political activism, utilizing analytical skills and engaging intersectoral collaboration, to lobby for greater autonomy for institutions that govern nursing and midwifery.       
  • Increase interaction between nurses and midwives and ministries of health to transform traditional policies and to implement best practices for primary prevention and wellness at community levels.           
  • Ascertain the extent that nurses and midwives are involved in implementing public health policies.                 
  • Ensure regulation of nursing and midwifery licensure. 
  • Include professions and entities with strategic influence outside of healthcare—e.g., the World Bank, the World Economic Forum—in the advancement of global health policy.
  • Educate lawmakers about evidence-based best practices for healthcare, and lobby for laws that promote healthy lifestyles.                         
  • Promote the implementation of legislation and regulation of nursing and midwifery education and practice in all countries.

Practice

  • Develop an integrated regional plan and system at all levels to address key health issues, such as mental health—i.e., infrastructure, programs, roles, resourcing, data collection and utilization, health information systems, political commitment—and integrate this plan at healthcare institutions and within communities. 
  • Promote an infrastructure that will maximize and support the quality and scope of nursing and midwifery practice.
  • Establish global standards for nursing and midwifery practice, inclusive of licensure, within the framework of regional context.        
  • Highlight the role of nurses and midwives in the distribution and administration of health promotion activities, e.g., immunizations and the impact of immunizations on disease prevention.
  • Develop and launch healthy lifestyle and resiliency campaigns in communities and schools. 
  • Use and rely on existing community-based services and programs to continue wellness promotion and disease prevention.   
  • Use an accountability framework to monitor and evaluate performance against targets.

Research

  • Document evidence of the contribution of nursing and midwifery to disease prevention and positive health outcomes regionally and globally.  
  • Advocate for policies that optimize research and the scope of evidence-based nursing and midwifery practice. 
  • Document the value of and need for increased research and research funding.

Workforce

  • Advance a systems approach to Human Resources for Health. 
  • Develop retention strategies for nurses and midwives.
  • Develop advanced practice roles, including competencies.
  • Increase diversity of the nursing and midwifery workforce in education and practice to reflect the populations served.
  • Create pathways that develop next-generation nursing and midwifery leaders to fill the projected leadership void across all areas.    
  • Ensure that nurses and midwives have autonomy to direct the needs of their professions, including hiring and workforce management roles.
  • Define nursing and midwifery roles and job responsibilities clearly in order to attract more people to the profession.               
  • Advocate for positive, safe, and healthy work environments for nurses, midwives, and all healthcare workers.
  • Campaign for investment in the nursing and midwifery workforce and strategies to improve the recruitment and retention of nurses and midwives. 

Principles

The following principles were established as a guide for those working to address the identified GAPFON strategies. 

Education

  • Educate nurses and midwives to implement evidence-based interventions across all settings to improve care and outcomes. 
  • Continue to expand nursing curriculum to support the maximization of the scope of nursing practice to meet country-wide and global challenges. 
  • Develop basic education programs that are oriented toward changing healthcare needs, are visionary for the future, and take global health issues and policies into consideration. 
  • Provide mechanisms to keep basic nursing and midwifery curricula updated and applicable to changing populations and service models. 
  • Teach nursing and midwifery students to understand the expectations of clients with ever-increasing access to healthcare information. 
  • Promote postgraduate education for nurses and midwives.

Leadership

  • Encourage inter- and intra-regional collaboration and regional meetings to discuss issues and ensure a cohesive approach to achieve global health. 
  • Promote public awareness campaigns regarding the role of nurses and midwives in healthcare. 
  • Encourage nurses and midwives to model healthy lifestyles. 
  • Encourage nurses and midwives to identify themselves as such when serving in public roles and when making public statements. 
  • Establish and participate in intersectoral collaboration to strengthen health systems and improve population health outcomes. 
  • Position nurses and midwives to demonstrate their leadership and care- coordination skills within a multidisciplinary health team. 
  • Combine innovation with evidence to lead in education, practice, collaboration, and technology.
  • Equip nurses and midwives in all countries with leadership skills that begin in their basic nursing education. 
  • Develop and mentor the next generation of leaders.
  • Cultivate and position leaders at all levels. 
  • Disseminate evidence of positive outcomes and cost-benefit of nursing and midwifery interventions. 
  • Increase number of nurses and midwives in elected government positions. 

Policy/Regulation

  • Partner with key strategic organizations to influence health policy at national, regional, and global levels. 
  • Develop and participate in national planning initiatives involving multiple stakeholders, e.g., disaster preparation and response. 
  • Learn from other countries’ successes that involve nurses and midwives in regulatory and public health leadership within regions and globally. 
  • Participate in and influence health policy and the global health agenda.
  • Influence evidence-based policy and legislation based on socioeconomic impact, knowledge translation, patient and public involvement, and advocacy to reduce inequalities in health. 
  • Promote advancement and election of nurses and midwives to decision- making positions in healthcare organizations and governmental and nongovernmental organizations (NGOs).
  • Align a united nursing and midwifery policy voice.  
 

Practice

  • Promote socialization of the family unit as a core for support, nurturing, and caretaking within the health continuum. 
  • Promote quality nursing and midwifery practice and education, including the development and promotion of community initiatives, social justice, and human rights. 
  • Promote quality nursing and midwifery practice in collaboration with, and informed by, patient and public involvement. 
  • Foster collaboration and sharing of opportunities to improve practice.
  • Promote regional cooperation to ensure a collective voice in expanding nursing and midwifery practice. 
  • Encourage more nursing and midwifery involvement in the development of e-health initiatives. 
  • Conduct ongoing assessments of nursing and midwifery interventions. 
  • Create collaborative networks of and among nurses, midwives, and organizations to focus on health issues and improve practice and standards.

Research

  • Replicate and disseminate studies that impact nursing and midwifery practice at regional levels to increase knowledge.  
  • Utilize evidence-based data to develop integrated regional plans that improve health at all levels—e.g., infrastructure, programs, health information systems, political commitment.      
  • Develop research studies to provide evidence for practice implications for health issues, e.g., mental health.
  • Mentor next generation of nurse and midwifery researchers/scientists.             
  • Utilize evidence to inform health policy in relation to the priority health issues.              
  • Strengthen nursing and midwifery’s impact on health policy and healthcare management through evidence.

Workforce

  • Campaign for a healthy and sustainable nursing and midwifery workforce. 
  • Ensure an adequate, competent workforce (numbers, skill mix, and education) that can deliver the right standard of nursing and midwifery care and that meet the demands of each country and region.
  • Strengthen workforce to promote capacity building and quality nursing and midwifery practice.
  • Create nurse-led interprofessional healthcare teams.  

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