I was pleased to join H.E. First Lady of Lagos State, Dr Mrs Ibijoke Sanwoolu MBBS, PGDHM, MPH, MBA, and HRM Oba Kabiru Sotobi, The Ayangburen of Ikorodu, alongside the Honorable Commissioner For Health represented by Permanent Secretary Dr Olusegun Ogboye, Mrs Kemi Ogunyemi HSC Commissioner IV, and Lagos State Health Service Commission Nurses led by Director of Nursing Services, Mrs Adebukola Cole, as Special Guests of Honour at the 13th Annual Nurses Scientific Conference of Lagos, to advocate for the gaps found in the nursing profession in Nigeria while developing a road map toward further investment and secure global health.
Nurses and midwives constitute the majority of the global health workforce and the largest health care expenditure. Efficient production, successful deployment, and ongoing retention based on carefully constructed policies regarding the career opportunities of nurses, midwives, and other providers in health care systems are key to ensuring universal health coverage, as the World Health Organization estimates that an additional 9 million nurses and midwives are needed if the world is to achieve UHC by 2030. Yet, daily, nurses are constrained by practice regulations, workplaces, and career ladder barriers solely from contributing to primary health care delivery, and improving the lives of others.
That is why together with our global partners and donors, during our implementation of our various programs such as Mamacare360 Community Midwifery Antenatal and Postnatal Education Program, EmONC upskilling for health workers, Medela Cares NICU Specific Lactation Support, Nutritional International LO-ORS Zinc to Combat Diarrheal Disease, we deliver a quadrupled dividend, to the health worker, health care facility, mother, and neonate, through improved health outcomes and empowerment while giving health care staff the opportunity to further their learning, training and education.
Combating the challenge of ensuring that nurses are assured of decent work, decent remuneration and a safe and dignified workplace is essential to the implementation and development of our programming and mission. Saving lives does not mean a nurse should risk her own. We hear constantly of nurses facing extreme adversities and barriers on the ground, from not only the lack of basic infrastructure and professional support to deliver high-quality care but to the lack of access to clean water and working spaces.
Health workers need clean water, adequate tools, equipment and medicine, to facilitate a safe and healthy delivery and support families’ health and hygiene needs across their lives. From health workers pulling buckets of water up from wells themselves, purchasing their own examination gloves, and digging makeshift pits themselves to dispose of medical waste, without access to WASH, and supplies and commodities needed to provide timely, high-quality care, our system will collapse. Effective supply chain management and procurement are needed so nurses can easily access life-saving medicines.
Positive and safe work environments are also a must, as the most trusted and engaged members of health care, and oftentimes sole point of access in rural communities, nurses must feel supported. At the workplace, there should be zero tolerance for sexual harassment and gender discrimination. Vertical segregation, where female health workers do not advance to higher leadership and remuneration as their male counterparts, needs to be addressed as it remains a challenge within primary health care and health systems.
To combat these hurdles, I believe there is a strong role for innovative multi-sector partnerships to play in helping accelerate progress towards security and investment in the health workforce and global health. The private and public sectors must collaborate with the local community and civil society, to improve the implementation and impact of the health workforce. The private sector plays an important role in most of the world’s health systems, from a mix of goods and services including direct provision of health services, medicines and medical products, and financial products, to training for the health workforce, information technology, and infrastructure and support services.
Investment into primary healthcare spaces, and in nursing-driven social care, is key to humanity’s survival in the current century. By investing in healthcare and the health workforce, we are solidifying solutions for local communities. We must work towards a comprehensive community health paradigm that will decrease delays in healthcare, bridge gaps in service delivery, ensure the highest quality of care, and create an integrated facility that can provide dynamic and comprehensive medical interventions and education.
Private sector investment can also tackle the issues of the retainment of young professionals and women. Women comprise roughly 70% of the global health workforce and perform the majority of the sector’s most challenging, dangerous, and labour-intensive jobs. Yet they hold only 25% of the health sector’s senior roles and are rarely represented adequately. Instead, they are often expected to remain passive actors, quietly finding ways to do their jobs in difficult – even impossible – circumstances.
Nurses are leaders, advocates and innovators. They are the largest, most trusted cadre of health workers and yet they have been largely overlooked and excluded from health policy discussions and investment decisions. As key players in health promotion and the backbone of healthcare systems worldwide, nurses work on the front lines as often the unsung heroes in health care facilities and emergency response.
Rebuilding and reinforcing every element of health care begins with investing in nurses for a secure global health future and is essential for resilient community health and wellbeing. We must urgently invest in nursing education and leadership training to improve recruitment, retention and respect within the nursing workforce. Based on the report by the World Health Organization (WHO) in partnership with the International Council of Nurses (ICN) and Nursing Now, I call on facilities and partners to increase funding to education and employ more nurses, strengthen the capacity to collect, analyse and act on data about the health workforce, monitor nurse mobility and migration and manage it responsibly and ethically educate and train nurses in the scientific, technological and sociological skills they need to drive progress in primary health care.
Despite the critical role they play in health care, there is a shortage of their voices at the table which must be addressed and strengthened on a Nation level. Therefore I am also calling for the establishment of leadership positions in government and development, we must ensure that nurses are allowed to fulfil their full potential, by improving working conditions through safe staffing levels, fair salaries, and respecting rights to occupational health and safety, implementing gender-sensitive nursing workforce policies, modernising professional nursing regulation by harmonising education and practice standards and using systems that can recognize and process nurses’ credentials globally.
In my remarks, I deeply appreciated the Award Of Honour bestowed upon me in recognition of the WBFA’s longstanding frontline programs at health facilities across Lagos State. I also took the opportunity to commend the Lagos State Health Commission’s declared investments into primary healthcare spaces, and nursing-driven social care, to achieving #UHC, 2030 #SDGs, and solidify solutions for local communities.
I pay tribute to nurses’ incredible work, professionalism, selflessness, courage, strength, and perseverance and express gratitude for their tireless efforts. Even in the face of exhaustion, stress, and physical and emotional trauma, nurses have inspired confidence and hope for the future. We must respect nurses’ rights and well-being to secure global health, and to do so we need massive investment in the acceleration of nursing education, creation of nursing jobs, and leadership. It is a fact that without nurses, midwives, and other health workers, countries cannot win the battle against outbreaks, or achieve universal health coverage and the Sustainable Development Goals.
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