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on a positive impact

Nurses & Midwives: We Can’t Succeed Without Them

By Professor Sharon Brownie, Dean Aga Khan University, School of Nursing and Midwifery in East Africa

When we reflect on the quality of a health system, we often ask ourselves how many health facilities are available. How many beds do they contain? Do they have the latest state-of-the-art equipment? But the most critical ingredient of all is whether or not the system has enough trained health workers to serve its community. As stated in the World Health Organization’s (WHO) universal truth, there is “no health without a workforce.” Without trained people to provide health services, the number of beds and equipment are of limited value.

Yet, these critical human resources remain below optimal levels and the world continues to experience a severe shortage of health workers. This is a reality we must profile and commit to solving during this World Health Worker Week. The shortage has particularly dire consequences in developing countries with already under-resourced and strained health systems. The WHO determined that a minimum of 23 doctors, nurses, and midwives are needed for every 10,000 people in order to fulfill essential health needs. In Kenya and Uganda, there are roughly half the required number of doctors, nurses, and midwives. In Tanzania, there is roughly a tenth of the required workforce.

Nurses and midwives working in low-resource health centers do their best to prepare for whomever walks through the door, regardless of the equipment or available colleagues to assist them. But this makes for difficult working conditions, like delivering a baby without clean water and a fresh pair of gloves, or working without vacations in sight because they are the sole health provider for their community. In the case of an emergency, there may be no doctor to provide specialist advice or no medivac service to transport a patient to a better equipped hospital. In places like these, a nurse like Aga Khan University Alumni Caroline Ndichu must have a wide range of skills well beyond their traditional roles, as well as the ability to think quickly and improvise. Their decisions can literally mean the difference between life and death.

As Dean of the Aga Khan University’s School of Nursing and Midwifery (AKU-SONAM) in East Africa (Kenya, Tanzania, and Uganda), I have the privilege of educating and supporting incredible nurses and midwives that are committed to serving their communities no matter how rich or poor. Over the past 15 years, AKU-SONAM East Africa has graduated more than 2,000 nurses and midwives with the support of the Johnson & Johnson Corporate Citizenship Trust (Trust). I’m proud to say that many of these graduates have risen to leadership positions across the region and are substantially contributing to the long-term sustainability of health systems.

The partnership with the Trust has strengthened the AKU-SONAM East Africa program in three particularly valuable ways. First, the scholarships provided by the Trust enable nurses and midwives to afford a program that would otherwise be out of reach. Second, we are able to continuously invest in improving the quality of education we offer and expand program offerings. For example, we have just introduced the first specialty diploma program in oncology for nurses in East Africa.


Third, the partnership has enabled us to devote resources to train nurses and midwives associations in the region. While nurses and midwives make up approximately 85% of the trained health workforce in East Africa, they tend to be overlooked for leadership positions and lack the chance to contribute to high-level decisions. Strengthening the associations is helping to reverse this trend and represent the interests of nurses and midwives in the health system.

As the largest percentage of the healthcare workforce in East Africa, nurses and midwives play a critical role in reaching the world’s Sustainable Development Goals (SDGs). This will require further investment in continued education and leadership opportunities for nurses and midwives, as well as nurturing future generations of these professions. Public-private sector partnerships like that between AKU and the Trust, are part of the solution to filling the health workforce gap and successfully reaching the SDGs.

This World Health Worker Week, join me in congratulating the nurses and midwives like AKU Alumni Caroline whose selfless service brings health care where there otherwise would be none. And join AKU and the Trust in committing to ensuring that life’s most joyous and challenging moments around the world are met by the competent and comforting hands of a skilled health worker.

Learn more about the Trust’s flagship partnership with the Aga Khan Development Network or watch this short video about upscaling nursing education in East Africa.

Professor Sharon Brownie, Dean Aga Khan University, School of Nursing and Midwifery in East Africa


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