Nursing the road to development

Friday February 8 2019


By Amin Mawji

This month, the Aga Khan University will award its 3000th certificate in nursing degrees and diplomas in East Africa. It is an important milestone in the long road to strengthening nursing capacity in the region.

Today, across the region, nurses provide care to a wide range of people, often with little support or resources. Yet, we see in different parts of the region, shortages of nurses with good generalist skills and speciality-based nurses.

This is why agencies like Aga Khan Health Services and the Aga Khan University have focussed their programmes on building capacity where it is most needed.

There are powerful reasons why strengthening nursing is an important plank in the development agenda.

Firstly, the impact of nurses on health outcomes is widely recognised across the world. Nurse-led care has been shown to lead to reduced costs, higher patient satisfaction, shorter hospital admissions, better access to care and fewer hospital acquired infections.

There is also evidence that nurse-led interventions for chronic conditions such as HIV and diabetes have resulted in patients making better informed decisions about their care.


Secondly, there is a strong empowerment dividend that flows from investing in nursing capacity. Developing and investing in nurses, the majority of whom are women, helps to empower them economically and as community leaders.

Thirdly, there is now strong evidence to demonstrate the link between investments in the health work force and economic growth. In recognition of this, the United Nations Secretary General announced, three years ago, the appointment of a Commission on Health Employment and Economic Growth.

The global economy is estimated to create around 40 million new health sector jobs by 2030 - mostly in middle-income and high-income countries.

Yet, despite the anticipated growth in jobs, it is estimated that there will be a projected shortage of 18 million health workers needed to achieve and sustain the Sustainable Development Goals primarily in low and lower-middle income countries.
The rising global demand for health-workers presents significant challenges over the coming years.

But it also offers the opportunity to generate employment, in areas where job creation is so needed. This is why the holistic approach of development agencies like the Aga Khan Development Network, focusses on the need to build capacity as well as create employment.

The aim is to develop relevant skills while also stimulating the creation of health and social sector jobs as a means of advancing inclusive economic growth.
But strengthening nursing is not simply about increasing numbers. It is about bringing world class training focussing on quality and, equally importantly, ensuring that the contribution that nurses make to our society, is properly valued.

It is a sad truth that world over, nurses are often undervalued and under utilised. The result is that they are very often not able to use their training to the full and work to their full potential.

We live in a world of enormous change in health and healthcare globally. Against this backdrop, it is impossible to tell how this will affect nursing.

What we do know is that there is a great deal of exciting innovation underway in nursing. Our challenge is to harness this spirit of enterprise and bring global best practice to our region here in East Africa.

At the same time, we must work harder to develop the best nurses and ensure that we value their contribution. Nursing leaders and practioners already know this. But they alone cannot bring about the change that is needed. Governments, development partners, non-nursing health leaders and others must work with them to change how nurses are perceived and what they are empowered to do.

If we get this right, we will find that strengthening nursing has the potential to contribute to regional development on three fronts: Improving health, promoting gender equality, and strengthening economies.

Mr Mawji OBE is the Diplomatic Representative of the Aga Khan Development Network based in Kampala.