Tag Archives: ICN

Primary Health Care & Universal Health Coverage 2024

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The International Council of Nurses (ICN) released an important discussion paper in September 2024. Nursing and Primary Health Care: Towards the Realization of Universal Health Coverage authored by David Stewart, Madrean Schober, and Howard Catton.

As I write this blog just after December 12 – Universal Health Coverage Day – it is an opportune time to reflect on the topic of the paper and its recommendations. The paper is well organized  making it easy to work through its main body and appendices. Brief case studies are interspersed showcasing nursing leadership and innovations in different health systems and contexts.

In the introduction, the authors point out many of the current realities that stand in the way of achieving universal health coverage: resource constraints, fragmented care, underutilization of nurses, and lack of teamwork. They trace key developments in the PHC movement referring to the major global conferences and declarations – Alma-Ata (1978) and Astana (2018) – emphasizing foundational principles of primary health care. I was glad to see the sidebar quotation (page 8) on the difference between PHC and primary care, often a source of confusion.

Chapter 1: The case for change reviews the challenges and documented gaps. The value of PHC in improving population health outcomes is highlighted here. The focus on patients and a greater orientation to community control are highlighted throughout the discussion as is the case for funding. The key role of PHC in public health emergencies is illustrated by the COVID-19 pandemic. This chapter ends with a timely reminder about the vital aspect of PHC in delivering vaccination programs. Nurses have a key role in managing and delivering immunizations to all age groups and in a multitude of community settings.

Chapter 2: Reimaging the possibilities of nurses in primary health care. This chapter focuses on roles including advanced practice and documents how countries are promoting team-based models. Details are provided in tables and illustrations as well as in the case studies. The authors note that digital health is becoming more relevant to PHC education and practice and encourage innovation by nurses in design of appropriate digital tools.

Finally, it’s worth reading the conclusion; I find myself in complete agreement with the points offered including this statement: “PHC should be at the highest priority for governments because it is the cornerstone of a sustainable health system.” (page 51).

Appendix 1 offers a summary of ICN’s recent work on PHC highlighting papers, position statements, media initiatives, and ongoing partnerships.

The summary of the authors’ recommendations found in Appendix 2 is a useful tool organized into four groupings:

  1. Care coordination
  2. Integrated and team-based PHC
  3. Advanced practice nurses
  4. PHC nursing workforce

The recommendations encompass ideas for health system change, advocacy, interdisciplinary education, and action by professional associations. One of the many nursing workforce recommendations is to “increase the voice of PHC nurses in policy development and high-level decision making” (page 55).

Reading this rich discussion paper and reflecting on the interesting case studies reminded me of visits to primary health care centres in past travels to Aotearoa/New Zealand, Australia, Nepal, India, and at home in Canada. I wrote about experiences in Japan in my August 2024 blog Public Health Nursing in Japan: Then and Now reflecting on strengths of their system as it has developed. My appreciation of the reality of PHC is rooted also in early career experiences in a community health centre in rural Manitoba and at the Alexandra PHC Clinic in urban South Africa. In my home province of British Columbia, I worked with a coalition that promoted the CHC model and development of a network leading to the establishment of the British Columbia Association of Community Health Centres. Sometimes I wonder why we haven’t made greater progress when so many well-established centres exist as models in many countries including Canada. 

An excellent resource in Canada is the Canadian Association of Community Health Centres with member CHCs across the country. As highlighted on its website CACHC is “the federal voice for Community Health Centres and community-oriented, people-centred primary health care across Canada.” Recent announcements following provincial elections in New Brunswick and British Columbia provide optimism for new centres on the horizon in 2025.

It has been a turbulent year in geopolitics including concerns about the interconnected issues of conflicts, environmental crises, and global health. The positive messages of the 2024 ICN discussion paper do offer us hope for a time when universal health coverage is realized.

By Nora Whyte – December 17, 2024

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Nurses in the News

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National Nursing Week in Canada is around the corner (May 6 to 12) and it is fitting to think about nurses in the news and how our vast experiences and perspectives are profiled. We often talk about the need for a much greater presence in the public media in our communities and around the country.

Two nurses who are bringing their expertise to the public discussion about health care in Canada are Amie-Archibald Varley and Sara Fung, co-hosts of The Gritty Nurse Podcast and authors of The Wisdom of Nurses. Since the release of their book, they are in demand for interviews and book signings. As I’m reading their book, I’m thinking about their questions and the multiple issues they raise about the profession. I’m pleased to see the attention the book is getting on social media and to learn that it has become a bestseller already.

Amie and Sara pose the question: “How many famous nurses can you name?” and then go on to share profiles of nurses from the past as well as current nurses who are well-known for their advocacy and contributions to changes in nursing and health care in Canada. They weave in their own personal stories – including their experiences in nursing school – as they describe their career paths in hospitals and, ultimately, the realization that they needed to make changes in their professional lives. They have included chapters by contributing authors to round out diverse voices and experiences.

I have no hesitation in recommending it and hope that readers will discuss it with people in their workplaces, in policy meetings, and in nursing schools across the country. Part of that discussion could explore the collective influence of nurses, thinking beyond one individual “famous nurse” to the groups of courageous nurses who came together to form nursing associations and unions not only in the distant past but also within the last 25 to 50 years. I’m thinking of the Canadian Indigenous Nurses Association, the Canadian Nursing Students’ Association, our national specialty groups, and the newly formed professional associations of the past 5 to 10 years, including the Nurses and Nurse Practitioners of BC in my home province.

Looking beyond our borders, we can celebrate the voice of national and global nursing organizations exerting their collective influence in reforming health systems and leading vital policy work. A great example is found in this recent announcement from the International Council of Nurses (ICN).

Dr. Cipriano, president of ICN will co-chair the global Steering Committee on Universal Health Coverage, known as ‘UHC2030’ with Dr. Magda Robalo:

UHC2030 warmly welcomes new co-chairs Dr Magda Robalo and Dr Pamela Cipriano – UHC2030

I feel fortunate that I have known famous nurses in my nursing lifetime, both in Canada and in countries I have visited for conferences and as a consultant. Memorable individuals and visionary groups of nurse leaders give me hope this Nursing Week.

By Nora Whyte – April 29, 2024

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Highlights of 2023

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My professional highlight of 2023 was attending the International Council of Nurses (ICN) Congress in Montreal in July. I wrote about the experience in my summer post on the ICN Congress and have been reflecting on both the content and organization of the event since then. I was glad to meet new people and also to renew acquaintances with colleagues, some of whom I am connected with on social media and enjoy following their updates and commentary.

Photo credit: Renata Mares

The ICN Congress provided opportunities to hear from people I follow such as James Buchan and Howard Catton who discussed their report published by ICN Recover to Rebuild: Investing in the Health Workforce for Health System Effectiveness. Their key message is “that without sufficient investment in well-supported nurses there can be no effective healthcare system recovery and rebuild” (Buchan & Catton, 2023, p. 4).

The experience in Montreal alerted me to watch for and share statements from Dr. Pamela Cipriano, ICN President, and Howard Catton, CEO, in the latter half of the year during the UN General Assembly and other global meetings. Continuing on its important ‘Nurses for Peace’ campaign, the ICN Board issued a strong statement in November on the Israel-Gaza conflict and maintains a dynamic presence on social media. See links below to recent statements:

UN Declaration on Universal Health Care

Universal Healthcare Day Statement

Climate and Health Declaration at COP28

Statement on the Israel-Gaza Conflict

In addition to the experience of the sessions at the ICN Congress, I participated in several webinars offered throughout the year including events hosted by the Canadian Nurses Association: the annual meeting in June and a town hall in September. A notable webinar at the end of the year was a highly informative session with Natalie Bryant from Australia featuring her current work on ‘Indigenist Critical Policy Analysis’. Grounded in the United Nations Declaration on the Rights of Indigenous Peoples, it is a framework for assessing organizational policies to determine whether they uphold Indigenous rights and address issues in their policy processes. I look forward to learning more about using the framework. Thanks to the BC Indigenous Health Nursing Research Program and the Nuu-chah-nulth Tribal Council Nursing Services Department for hosting this session.

My consulting focused on work with the Nuu-chah-nulth Tribal Council as we concluded a community-based research project last year. As a team member, it was satisfying to have our article published in the Canadian Journal of Nursing Leadership:

Watts. J., Bourque Bearskin, L. Blackstone, D.  Christiansen, S. Young, K., Charleson, J., Charleson, R., Fraser, J., Sangster-Gormley, E., Dick, V., Duncan, S., & Whyte, N. (2023). Nursing the Nuu-chah-nulth Way: Communities driving nursing policy priorities. Canadian Journal of Nursing Leadership, 35(4), 55–67. doi:10.12927/cjnl.2023.27073

Another major highlight was the 50th Reunion of our UBC School of Nursing Class (BSN 1973) in May. It was a great, happy time of reminiscing and also gave us a chance to have conversations with classmates about our careers, families, and current interests. We spent time on the UBC campus and had a lovely evening at the Vancouver home of a classmate, Sherri Adams. The reunion committee did a fantastic job of arranging this milestone celebration!

My personal and professional worlds are intertwined in multiple ways. I think back on discussions this past year with a core group of friends and colleagues where the topics have covered writing and reading, conferences, career and retirement decisions, personal changes, the state of the world, travel, and gardening. Supportive friends, family, and close colleagues make it all worthwhile as the years go by.

By Nora Whyte – January 5, 2024

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Winter 2023 in the Comox Valley

ICN Congress 2023

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Volunteers welcoming delegates
Credit: Renata Mares

The International Council of Nurses (ICN) held its 2023 Congress in Montreal from July 1 to 5, co-hosted by the Canadian Nurses Association. It marked the first in-person congress since 2019 and attracted 6,200 nurses from 145 countries. 

Delegates at ICN Congress, in national dress, before opening ceremony.
Delegates before opening ceremony – July 1st.

The congress theme – Nurses together: a force for global health – was evident throughout the event with inspiring plenary sessions by global leaders. In particular, I enjoyed several panel presentations featuring leaders from different countries and two policy cafés facilitated by ICN staff. Although it was impossible to take in all the presentations, it helped to talk with other participants about sessions they had attended. A customized congress app provided the daily schedule and access to all the abstracts and e-posters; it served as a useful tool throughout the event and to review information later.

Three volunteers at Booth at ICN Congress.
Volunteers at ICN Booth
Credit: Renata Mares

Plenary sessions focused on nursing workforce issues in the aftermath of the pandemic. I noticed greater awareness about ethical international recruitment practices and the urgency to ensure safe working environments. ICN leaders highlighted the new Charter for Change directed at government policy actions as the focus of a campaign, “Our Nurses. Our Future.” On the final day, we listened to powerful video presentations by nursing leaders living through current conflicts and disasters; we were touched by their courage in the midst of all the losses they have experienced.

Policy café: (Left to right) Mr. Howard Catton,
Dr. Amelia Tuipulotu & Dr. James Buchan

The new WHO Chief Nurse, Dr. Amelia Latu Afuhaamango Tuipulotu, was an active presence throughout the congress (and I was so pleased to have had a chance to speak with her at the end!). She moderated an excellent session on the current global agenda for nursing and midwifery in the context of Universal Health Coverage and also spoke about the importance of nurses’ voices in health policy.

Personal highlights included seeing people I’ve known over the years, especially nursing leaders from other countries and Canadian friends and colleagues. As we’ve remarked to one another, the mood was somewhat sombre and we sensed the fatigue nurses have experienced from the pandemic period along with global conflicts and humanitarian disasters. Some of the usual excitement found in these gatherings was missing although many attendees were enthusiastic about the opportunity to be together in Montreal. I especially enjoyed hearing impressions from first-time participants.

Outdoor Break at Congress Centre

Social media provided a glimpse into participants’ reactions to sessions and meetings throughout the congress. It gave us a sense of what was happening and who was attending; I made some new social media connections too! The ICN team sent out a daily summary each evening and used the app to notify participants of the next day’s sessions. The entire event required comprehensive planning and communication. Thank you to all the board members and staff of ICN and CNA for your leadership, along with many nurses who served on committees. The on-site volunteers – visible in their red shirts – were a great help to participants throughout the five days.

Dr. Carolyn Pepler & Renata Mares
Credit: Renata Mares

At the closing ceremony, a new ICN logo was launched – now featured on the revamped website. Visit the ICN Website for summaries of the congress and informative items about pre-congress meetings including the Student Assembly and the Council of National Representatives. During the closing ceremony, the Finnish Nurses Association issued a lovely invitation to the next ICN Congress to be held in Helsinki in June 2025. Please see this summary of the closing session: ICN Congress in Montreal closes with inspiring ceremony and the launch of its new visual image and logo | ICN – International Council of Nurses

By Nora Whyte – July 26, 2023

Updated: July 30, 2023

Thanks to Renata Mares for her kindness in sharing her photos of ICN volunteers and for giving me permission to use them in this post.

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

New ICN Campaign: “Our Nurses. Our Future”

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The International Council of Nurses (ICN) launched an exciting new campaign – “Our Nurses. Our Future.” – on International Nurses Day, May 12, 2023. A key resource is a ten-point Charter for Change that provides guidance for the future.

Courtesy of ICN – 2023

The first point sets the tone for global health action:

“Protect and invest in the nursing profession to rebuild health systems that can deliver the Sustainable Development Goals and Universal Health Coverage to improve global health. Recognise and value health and health care as an investment not a cost. Secure commitments for investment to maintain equitable and people-centred care.“

Each point is worth attention and action this year. I will reflect on point 8 as we prepare for the ICN Congress in Montreal this July:

“Actively and meaningfully engage national nursing associations as critical professional partners in all aspects of health and social care policy, delivery and leadership as the experienced and trusted voice of nursing. Build local, national and global multilateral partnerships.”

On this day, I am reminded of warm connections with international colleagues I have met through partnerships, exchange visits and conferences over many decades. In particular I’m thinking about the nurses, faculty members and students at Guru Nanak College of Nursing in Punjab and my friends at the Canada India Education Society and UBC School of Nursing. The hospitality and conversations were wonderful! Also remembering nurse leaders I met and admired in the Japanese Nursing Association and the Democratic Nursing Organization of South Africa (DENOSA). Thank you and best wishes for International Nurses Day and beyond!

By Nora Whyte – May 12, 2023

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Congress Banner courtesy of ICN.

Updates on Nursing Associations 2022

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Parksville, BC – June 2022

I’m writing this update at the end of June in advance of our summer break in Canada. World events in the first half of 2022 have left us shaken and concerned about the future as we grapple with climate issues, global conflicts, food security, and population health. As I follow the daily news, I also turn my attention to developments in nursing and look for statements and opportunities for advocacy.

ICN Updates

The 75th World Health Assembly took place in May. It was interesting to follow on social media as it generated considerable attention this year. The International Council of Nurses (ICN) was active in presenting ‘Interventions’ on specific resolutions. See ICN’s summary here.

ICN along with the International Confederation of Midwives and the WHO met for their 9th Triad meeting in May. The representatives issued the 2022 Triad Statement focusing on health care workforce issues and reporting on what countries are doing in response to the Global Strategic Directions for Nursing and Midwifery 2021-2025. Howard Catton, ICN CEO, has been interviewed by many news media this year speaking about the war in Ukraine and related humanitarian crises and on the scale of the nursing shortfall globally.

Annual Meetings

The Canadian Nurses Association (CNA) and the Association of Nurses and Nurse Practitioners of BC (NNPBC) held their annual meetings in June. Both were open to all members and observers in a virtual format. The CNA Meeting of Members was noteworthy because it marked the first time that individual members could vote to elect candidates for the Board of Directors and vote on AGM motions. The previous federation model of territorial and provincial member associations carrying votes has ended. As a member who is following these changes, it will be interesting to see how the new membership structure will work and how the new Board will communicate with members throughout the country.  

After both meetings, I was left somewhat disappointed that there wasn’t more substance presented on what our associations are doing to demonstrate leadership during the current health care staffing crisis and other major issues in 2022 (I receive newsletters and view social media updates but others may not). I do recognize that annual meetings present highlights and financial statements on the previous year and are always six months out of date for the current year’s activities. It makes me wonder if members would be interested in (and commit to attending) an organizational update given in the autumn each year. We could meet the new Board members, hear their priorities for the current year, and ask questions – all through a virtual format, and in a less formal manner than at an annual meeting.

Annual meetings and major events aside, I do appreciate the ongoing work of our professional associations at all levels to bring a nursing perspective to provincial, national, and global health challenges and policy change.

By Nora Whyte – June 27, 2022

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

Save the date for July 2023!

Nurses for Peace

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ICN Campaign: Nurses for Peace

The International Council of Nurses (ICN) has launched a #NursesforPeace social media campaign to join nurses around the world in solidarity with the nurses of Ukraine.

ICN in partnership with the European Federation of Nurses Associations (EFN) and the European Forum of National Nursing and Midwifery Associations (EFNNMA) issued a powerful statement on March 3, 2022. Speaking on behalf of the global nursing community, they condemn the illegal invasion of Ukraine and call for an immediate ceasefire.

ICN is encouraging nurses around the globe to participate in the social media campaign and to add our support by signing the statement.

Thank you to ICN and European partners for your strong leadership at this critical moment and for demonstrating support for the Ukrainian people in this call for humanitarian action. For updates and suggested actions, please visit the ICN website.

#NursesforPeace

By Nora Whyte – March 3, 2022

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

Year in Review: 2021

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ICN Congress

A highlight of 2021 was the opportunity to participate in the International Council of Nurses (ICN) Congress, held in a virtual format for the first time. The ICN Board and Staff team along with congress partner Emirates Nursing Association did an outstanding job of hosting the three-day event attended by 5,000 nurses and guests from around the globe. Speakers and participants added to the richness of the discussions on key topics relevant to nursing today and conveyed the sense of urgency on workforce issues and equity in global health. Among the important documents discussed was the Global Strategic Directions for Nursing and Midwifery 2021–2025 released in April 2021 by the World Health Organization. Four focal areas for health systems – education, jobs, leadership and service delivery – were important strategic directions covered in congress sessions.

I enjoyed the daily keynote presentations and the continuity provided by ICN leaders who conveyed the enthusiasm and spirit I had experienced at past congresses. However, I did miss the informal social gatherings and memorable encounters with nurses from other countries at congresses in Singapore (2019), Barcelona (2017) and Durban (2009).

Prior to the congress, I was pleased to continue my collaboration with Patrick Chui and Susan Duncan in planning a presentation delivered by Patrick as a pre-recorded oral concurrent session. The presentation drew on previous work and explored policy advocacy leadership by Canadian nursing organizations using a current example of COVID-19 vaccine equity. We discussed ways in which nursing organizations demonstrate policy advocacy leadership in highly complex and evolving contexts. In our conclusion we proposed areas of research that will be useful in generating knowledge to strengthen nursing organizations’ influence on health systems and policy.


Professional Development Highlights

Webinars were the way to go for professional development this year. I enjoyed sessions organized by the Canadian Nurses Association throughout 2021 and the Annual Marion Woodward Lecture hosted by UBC School of Nursing in November. A stimulating session in December was hosted by the International Collaboration for Community Health Nursing Research (ICCHNR): Dr. Barbara Stilwell delivered the annual Lisbeth Hockey Lecture on The Power of the Nursing Narrative. I liked Barbara Stilwell’s call to nurses: “Let’s power together” as she concluded her lecture. Thank you to the organizers and speakers for contributing to my learning and thinking during the past year.

A New Roadmap

Looking to this new year and beyond, the WHO Regional Office for Europe has published Building Better Together: Roadmap to Guide Implementation of the Global Strategic Directions for Nursing and Midwifery in the European Region.  As noted in the foreword by Hans Kluge, WHO Regional Director for Europe, “…we will work over the next five years to ensure that nurses and midwives have the capacity to contribute to key areas of public health, primary care, long-term care and post-COVID-19 recovery. We will put this into practice through relevant education, improved working conditions, the promotion of leadership opportunities and clear career pathways.” (WHO, 2021, p. v).  Taking into account regional and global policy contexts, it lays out key directions and monitoring mechanisms.  It’s an excellent resource that may serve as a guide for other regions to follow.

I end my year in review comments with a special note of appreciation to all the colleagues who continue to involve me in fascinating projects and who stay in touch through regular email exchanges and on social media. Thank you to my Twitter followers!

By Nora Whyte – January 4, 2022

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

Global Nursing Reports: May 2021

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Each year at this time I write a short piece to reflect on National Nursing Week in Canada and follow what others are posting on social media. This year there isn’t much to say that hasn’t been said already by nursing leaders and through Canadian media coverage of nursing during COVID times. I do want to commend leaders in nursing organizations and to thank colleagues for the tremendous work they have been doing under such difficult circumstances. I think about nurses I have known in India, Nepal, and South Africa and wonder how they’re doing. I hear stories about nurses in all parts of Canada who continue to be key to the COVID response and I learn from colleagues in my circle about their recent experiences with the vaccination rollout in British Columbia.

International Council of Nurses May 2021

ICN celebrates International Nurses Day on May 12 each year. This year, it has released an excellent report Nurses: A Voice to Lead – A Vision for Future Healthcare. The report calls for nurses to become the “architects and designers” of health systems, not only the people who deliver care. Among the report’s key recommendations are that governments embrace this new global strategy for nursing and embed its recommendations into their national healthcare strategies.

A graphic that captures the vision for future health care is found on page 7 highlighting the report’s framework and recommendations. It lists six aspects of health care transformation and five ways to support nurses to leverage a better health system. Transformation includes a renewed emphasis on public health nursing, investments in innovation along with greater attention to quality and affordable care. Approaches for supporting nurses focus on safe workplaces, valuing the role of nurses, and better access to education and professional development. This year’s report provided information on a survey of National Nursing Associations on aspects of the COVID response and current issues for evolving the profession. The report is illustrated with country spotlights from the nursing associations and media reports.

Another major report published this month marks the culmination of the global Nursing Now campaign – Agents of Change: the story of the Nursing Now campaign. Although I had followed the campaign since its launch in 2018, I hadn’t been aware of all the impressive accomplishments described in the report. The appraisal of the process and outcomes to date are worth reviewing; it is interesting to know that the reach extended to 729 Nursing Now groups in 126 countries. There’s a strong message to build on the campaign’s momentum as noted on page 14:

“The Nursing Now campaign has generated tremendous energy from nurses and their allies. They have truly come together as agents of change. It is critical at this pivotal moment, as the world turns its attention to rebuilding health systems for the future, that nurses do not lose this momentum.”

Holloway et al. (2021).

A final note for nurses with an interest in global health policy, ICN’s Global Nursing Leadership Institute (GNLI) is worth exploring as a career development step. BC’s Angela Wignall shared her enthusiasm and described her recent experience as a GNLI scholar in a two-part blog for the Nurses and Nurse Practitioners of BC: Part 1 on the ICN Global Nursing Leadership Institute and Part 2 on Nursing Bodies: Learning from Global Examples. To learn more, please see the GNLI program overview with details about the program and the application process.

By Nora Whyte – May 22, 2021

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

References:

Holloway, A., Thomson, A., Stilwell, B., Finch, H., Irwin, K., and Crisp, N.(2021). Agents of Change: the story of the Nursing Now campaign. Nursing Now/Burdett Trust for Nursing. London.

International Council of Nurses. (2021). Nurses: A Voice to Lead – A Vision for Future Healthcare. Geneva.