Influencing and persuading: the need to increase government access to nursing policy advice

Abstract

Nurses throughout the world are crucial to building and strengthening the health care systems within which they work. For this reason, the collaborative engagement of nurses in health policy development must be a priority for all governments. In its Strategic Directions for Strengthening Nursing and Midwifery Services 2011–2015, the World Health Organization (2010) clearly states that despite the centrality of nurses across health care settings, they are frequently excluded from health policy deliberations. The strategy provides an action framework aimed at overcoming this reality that complements precisely the international goals I have identified for my ICN Presidency. ‘Access’ is the watchword I have chosen to reflect these goals. That is, through ICN, I am promoting efforts to increase access by patients to health services; to increase access by nurses to education; and to increase access by governments to nursing policy advice. Increasing access by governments to nursing advice presents a twofold lobbying challenge for the nursing profession. First, a prevailing problem in many countries is a lack of quality data sources that capture the detail of nursing activity. Reliable information and data collection systems are essential to the provision of robust policy advice. Without such mechanisms the capacity of the profession to build and present persuasive policy positions is restricted. To address this, nurses must communicate to governments the need for sound nursing sensitive data systems that provide effective surveillance of nursing activities and their related impacts. The second part of the challenge is convincing governments of the value of nursing advice so that it is systematically sought to inform health care planning and reform at all levels. Nurses are the key source of information and expertise on the services and the service mechanisms they manage and deliver. Moreover, being on the frontline, nurses can provide valuable perspectives on the population health needs of the communities they work with and within. It must be articulated to governments that much of this information is uniquely understood by nurses and its inclusion is vital to good policy development and decision-making. Failure by governments to seek advice from the predominant health professional group would result in a failure to adequately scope and examine health policy options. Confronting these challenges requires a concerted lobbying effort, which, while not limited to, must fall within the remit of our national nursing associations (NNAs). NNAs must organize intra-professionally as well as with other stakeholders to promote collaborative engagement with policy-makers to communicate nursing issues and to convey nursing experiences. It is also within the purview of the ICN to support NNAs in this endeavour. The presence and involvement of the ICN at the national level can catalyse engagement between the nursing profession and national governments. I have experienced firsthand that a country visit by the President of ICN can trigger a meeting of the nursing profession and government officials, often for the first time. Health ministers, and on one occasion a president, have expressed their gratitude for the health policy input we and our accompanying NNA have been able to contribute through ICN's in-country participation. It is my hope that these and future visits will have the lasting effect of seeing governments continue to seek relevant information from NNAs. Ensuring health governance is informed by the best possible nursing advice is essential given that nurses are frontline delivers of health services across acute, ambulatory and primary health care sectors in all nations. Without nurses, the health of communities across the globe would be detrimentally affected. Nurses must understand that the exchange and provision of good-quality nursing information contributes to the strengthening of the greater health system. Sharing nursing experiences, evidence and information can facilitate better health policy formulation and implementation and positively influence health priorities at local, national and international levels.