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Revista da Escola de Enfermagem da USP

Print version ISSN 0080-6234On-line version ISSN 1980-220X

Rev. esc. enferm. USP vol.49 no.6 São Paulo Dec. 2015 


Challenges of Nursing in the context of the Development Agenda post-2015

Isabel Amélia Costa Mendes1 

1Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem no Brazil, Ribeirão Preto, SP, Brazil.

Clear messages have been addressed to the international agencies, to the governments, to the public policy makers, to the educational institutions of human resources in health, advocating and alerting to: 1) the need to numerically and qualitatively expand the education and supply of health professionals globally, although the solution depends on strategic decisions in the selection of the best talents, places, contents and training models, on the focus on appropriate skills for each context and on investments in competency development in the course of professional life, involving multidisciplinary teams;2) the increase in the number of health professionals is necessary, but insufficient to reach the target of universal access and coverage of the entire community. It is fundamental for the service supply to be based on strategic planning that comprises geographic, financial and motivational indicators, capable of attracting and retaining the health professionals in the places where they are most needed1.

In this context, and in view of the evidences, it is of paramount importance to invest in other core elements for the achievement of targets and for the sustainability of the policies adopted in terms of access, coverage and quality of care.

The literature reveals forceful positions that evidences are not always transformed into policies and into practice and that there are no shortcuts on this route(1-2),turning universal health coverage into a moral imperative 3.

These challenges underlie the discussions about the efforts to achieve universal health coverage and the sustainable development targets post-2015, in which the human resources play a central role.

It is only through systemic action that all barriers can be overcome to face and overcome the huge challenge in human resources for health; it is only through sustainable political commitment that a base can be offered for local and global action 4,which demands converging and complementary actions in each area.

Considering that, in global terms, Nursing and Midwifery represent about 70% of the health workforce, and that they lead multiprofesional health teams in many countries, it is easily concluded that these frontline professionals are fundamental, and understood that any numerical or qualitative deficiency in their profile seriously affects the results of these services provided to the population(5-6), to whom a dignified life should be granted.

After the conquest of the Millennium Development Goals (MDG) and the UN's definition process of the post-2015 Development Agenda 7, a context is outlined in which Nursing and Midwifery gain further focus, in line with the policy and decision makers' understanding about the central role of human resources in health.

The adoption by consensus of the resolution about the universal health coverage and the demand for basic and highly specialized care evidences Nursing and nurses' actual participation in the supply of care as well as in decision making and in the formulation of evidence-based policies.

To cope with such a challenge, the educational and employment institutions of nurses need to make correct decisions that promote these professionals' valuation at school and work, permanently investing in their knowledge, strengthening their leadership, research competences and respective documents as the base for informed decision making. Institutional encouragement is fundamental but insufficient to guarantee the nurses' self-valuation and self-confidence:the global acknowledgement of the importance of nurses for health systems and for the conversion of policies into outcomes need to resound in the health departments of all member countries of the World Health Organization and from the health departments to society. Prepared and valued nurses who offer results and solutions serve as the engine for the development of Nursing, reflecting in the awakening of vocations. This, in turn, can trigger an increase in the demand for places in nursing programs, dignified work conditions and career retention.

The Nursing schools also need to know how to prepare their teachers to receive the (undergraduate, graduate and continuing education) clients, being accountable for contributing to the target of population health and wellbeing, equating the lack of nursing that is so urgent and threatening today.

Let us make use of the opportunities the context is offering to conquer the empowerment of Nursing and an image adjusted to its true value!


1 Campbell J, Buchan J, Cometto G, David B, Dussault G, Fogstad H, et al. Human resources for health and universal health coverage: fostering equity and efecctive coverage. Bul World Health Organ. 2013;91(11):853-63. [ Links ]

2 Campbell J. The route to effective coverage is trough the health worker: there are no shortcuts. Lancet. 2013;381(9868):725. [ Links ]

3 Etienne CF. Achieving universal health coverage is a moral imperative. Lancet. 2015;385(9975):1271-3. [ Links ]

4 Sales M, Kieny MP, Krech R, Ettienne C. Human resources for universal health coverage: from evidence to policy and action. Bull World Health Organ. 2013;91(11):798-8. [ Links ]

5 World Health Organization. Health workforce. Moving the nursing agenda forward [Internet]. Geneva: WHO; 2015 [cited 2015 Oct 29]. Available from: Available from: ]

6 World Health Organization. Global Advisory Group on Nursing and Midwifery: 2013 review [Internet].; Geneva: WHO 2013 [cited 2015 Oct 29]. Available from: Available from: ]

7 United Nations. The Millennium Development Goals and Beyond [Internet]. New York; 2015 [cited 2015 Oct 27]. Available from: Available from: ]

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