Over the last few years, I have attended conferences and symposia on differing aspects of global health. These gatherings have been notable for the inclusion of panelists from a wide range of disciplines and experiences: advocates, anthropologists, bench scientists, biostatisticians, community health workers, economists, epidemiologists, human rights lawyers, managers, physicians, politicians, public health specialists, and those who may be living with the condition under discussion. Every facet of health policy, implementation, monitoring, and evaluation is touched upon by the expert panel. Almost.  Distinguished nursing colleagues are present, but only in the audience.  When the organizers are asked as to why nurses are not included on the stage, their responses vary, from avoidance to defensiveness, to simply admitting that they did not think of it.   They did not think of inviting experts from the discipline that, globally, comprises 50-60% of the entire health care workforce, and as high of 80% of professional staff. (1)

When The Lancet, one of the premier medical publications in the world, announced the creation of an on-line, open access journal, Lancet Global Health, I was excited.  This journal would focus not just on medicine alone but also on the broader aspects of global health. The 21 person international advisory board featured a multi-disciplinary mix of accomplished men and women from all over the globe– but no nurses.

By our omission, Nursing is not considered an essential profession to those at Lancet Global Health, World Health Organization, or at many other places where policy is created which changes our work and the lives of those whom we serve.   We must consider the impact associated with our exclusion: The failure of so many initiatives in health may stem from the fact that those of us who have to implement the bulk of the work are not included in its design.

This was the gist of the argument that I posted to the Nursing and Midwifery group in Global Health Delivery online. We are more used to advocating for our patients or, occasionally, for better wages, but are less comfortable with advocating solely on behalf of our profession. By seeking input from other nurses on a global platform, we were able to discuss our role in general and our place in setting the agenda in global health. My colleagues agreed that it was time to advocate for our profession’s role as essential for creating effective policy and practice in global health.

Our letter campaign provoked a very credible response by Zoe Mullan, the editor of Lancet Global Health. To her great credit, she listened to our argument, and agreed with the premise. She sought and received our input on potential nursing scholars to sit on the advisory board, ultimately choosing on of our candidates:  Dr. Naomi Mmapelo Seboni, PhD, RN, RM, President of the International Planned Parenthood Federation, is now on the advisory board of Lancet Global Health.

This is a small, yet positive step for nurses. To improve the health and well being of our patients as well as ourselves we must be the drivers of policy and program implementation rather than being driven by others’ decisions. Welcome to the Year of Advocacy for Global Health Nursing.

Elizabeth Glaser MSc, MA, ACRN, RN-BC

GNC Board Member

1. WHO. Health workforce: Disaggregated data. http://apps.who.int/gho/data/node.main.HWFGROUPS?lang=en