ICN: ‘Nurses a Voice to Lead – Health is a Human Right’

“Nurses a Voice to Lead – Health is a Human Right,” the report and toolkit of the International Council of Nurses (ICN) for 2018 for International Nurses Day (IND) was released earlier this year. This was in conjunction with the launch of the Nursing Now campaign of February 27. The primary focus is access to person-centered health care for all – when, where, and how they need it – and nursing’s central role in achieving this.

“All over the world there are individuals and communities who are suffering from illness due to lack of accessible and affordable health care,” said Annette Kennedy, President of the ICN in her introductory message. “This International Nurses Day, let us join together to share how nurses are transforming health care and health systems so that no person is left behind. Let us join our voices together to be a voice to lead by supporting a people-centered approach to care and health systems, and ensuring our voices are heard in influencing health policy, planning and provision.”

The report emphasizes that to achieve real health and well-being for everyone requires a restructuring of the current biomedical model of health care, with its emphasis on pathology and treatment, to a person-centered approach where the focus is on the personal, social and economic determinants of health. It is here that nursing can make a significant contribution – the philosophy and foundation of nursing practice is a people-centered approach and caring holistically for the health and well-being of individuals.

The report clarifies the different dimensions of access to health care and provides, for each of these dimensions, inspiring case studies of services across the world where nurses are making a difference in providing more accessible and person-centered health care to communities. In its broadest sense, access incorporates all the complex factors, related to both the health service user and provider, that enables people to contact and receive health care according to their needs and then having those needs met.

In the first place, the person has to be aware that they have an unmet health care need and this is where it is vital to take services to communities. Then they need to know what services are available as well as have access to the required health care. Furthermore, they must have trust in the service if they are to utilize it and this requires a human rights approach where care is culturally appropriate and non-discriminatory. The service must be available and accessible – and this often poses challenges especially for those in rural areas, the disadvantaged and the most vulnerable in the community.

Access also relates to affordability not only of the service but also concerning the hidden costs such as travel, childcare, and the patient missing work. It is estimated that in lower and middle-income populations 6-17% of people end up in extreme poverty due to medical expenses. Access further implies the availability of safe and high-quality care — services must be acceptable and effective, providing a positive experience for the user. For example, long waiting times is known to reduce utilization of services and poorer outcomes. Effective services also require sufficient, skilled and motivated staff who are appropriately deployed.

There are three central policy directives that policymakers should accept to enable health as a human right and improve access to care. These are a commitment to universal health coverage, people-centered care and providing adequate human resources for health. It has been shown that investment in the health of populations contributes positively to economic development, with the economic benefits being far greater than the costs. Improving health systems requires bringing nurses to the policy-making table at all levels to harness their understanding of the strengths and weaknesses of current health systems in meeting the needs of communities, as well as their knowledge and commitment to the well-being of individuals.

“Nurses can be a voice to lead by improving access to care; enabling a people-centered approach to health; and by ensuring their voices are heard in influencing health policy, planning, and provision,” the report concludes. “In 2018 it is now time to stand together and speak as one. We must speak louder. We need to speak clearer.”