How nurses and midwives are essential to achieving universal health coverage

Two female nurses laughing and smiling.

By Nicolette Davies, IGHI’s Head of Operations

Universal Health Coverage (UHC) is a basic human right. The WHO’s Director-General, Dr Tedros Adhanom, continues to highlight the importance of UHC by focusing its World Health Day on this topic. Dr Tedros’ top priority is equity for health for all, but how will we achieve the World Health Assembly’s ambitious target of 1 billion more people benefiting from UHC within five years?

The World Innovation Summit for Health in partnership with the Institute of Global Health Innovation sought to address these concerns. The collaboration recently launched a policy report highlighting the fundamental role nurses and midwives play in delivering UHC. As we approach the 200th anniversary of Florence Nightingale’s birth, it’s timely to showcase the all-important contribution that nurses and midwives offer to the heart of every health system. And this becomes more crucial in today’s society that is faced with increasing public health, social and economic challenges.

Unsung heroes of healthcare

Globally, nurses and midwives represent half of the professional health workforce. They play a critical role not only in delivering healthcare to millions around the world, but also in transforming health policies, promoting health in communities, and supporting patients and families. This report, as highlighted by the Forum’s Chair and Co-Chair of the Nursing Now campaign, Lord Nigel Crisp, argues that investing and developing the nursing and midwifery workforce can achieve rapid, cost-effective expansion of high-quality UHC.

This makes sense – nurses account for 90% of interactions between health professionals and patients and can make an increasing contribution to service quality. Often, they may be the first or only health professional that a patient may see. Many also have a closeness with the communities that they serve, providing support with disease prevention, health literacy and health promotion.

By being at the heart of the community, nurses are best placed to provide the level of care that is required to meet the increasing global health challenges such as age-related conditions and the growing number of people living with non-communicable disease.

Overcoming obstacles

But as obvious as these benefits may seem, nurses and midwives from around the world report that they feel undervalued and that their true potential is not understood. This is often accompanied by under-resourcing, not being enabled to work to ‘the limit of their license’ and rarely being involved in high-level decision-making regarding planning and policymaking.

This is an amazing waste of talent and recourses, so how do we remove these barriers to progress?

We need greater investment, as well as a necessary shift in policy at a national and global level, to recognise what nurses and midwives can achieve if enabled to do so. There are already many nurses who have taken on more advanced and specialist roles, and globally many midwifery- and nurse-led services provide new and innovative models of care. By empowering nurses and midwives and developing their roles as part of a multi-disciplinary team, they can and will have a positive impact in spreading UHC cost-effectively, rapidly and to a high level of quality.

Nursing and Midwifery: The Key to the rapid and cost-effective expansion of high-quality universal health coverage, was published by the World Innovation Summit for Health and Imperial College London’s Institute of Global Health Innovation in November 2018. The report is available at

Leave a Reply

Your email address will not be published. Required fields are marked *