Enhancing the role for community health nursing or universal health coverage

Overview

Universal health coverage (UHC) is a concept that refers to the ability of all individuals and communities to access quality health care without suffering undue financial hardships. For UHC to be successful in countries, an effective and well-functioning primary health care (PHC) system is essential.

The goal of achieving UHC will be undermined if concrete steps are not taken to protect, motivate, increase and retain adequate numbers of skilled, well-educated and trained health workers in countries. The health care workforce is a major building block of health systems. The focus of this paper is on community health nursing (CHN) and community health nurses’ (CHNs) contribution to UHC. Community health nurses have the potential to make significant contributions to meet the health care needs of various population groups in a variety of community settings. In order to assess the extent to which CHNs are achieving this potential, WHO conducted a study between 2010 and 2014 that examined the status of community health nursing in 22 countries, 13 of which were experiencing a critical shortage of health care workers.

The study revealed that the countries surveyed had the basic and operational framework for optimizing CHN in their health systems as evidenced by the availability of PHC structures to guide interventions. However, challenges were identified related to the education, practice and management of CHNs in these countries.

The major challenges identified were: Limited availability of career opportunities; poor worker retention; low recognition for CHNs; inadequate and unsupportive working conditions and environments; absence of educational standards; varying educational entry-level requirements for CHN programmes; and a lack of consensus on the scope of practice for CHNs.

These challenges were derived from the five key areas of the study focus: