The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments

The International Year of the Nurse and the Midwife Taking stock of outcomes and commitments N U RSING AND MID W IF ER Y

The International Year of the Nurse and the Midwife Taking stock of outcomes and commitments N U RSING AND MID W IF ER Y The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments ISBN 978-92-4-008192-5 (electronic version) ISBN 978-92-4-008193-2 (print version) © World Health Organization 2023 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. 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The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. iii Contents + Executive Summary v + 1. Background 1 + 2. Methods 1 + 3. Outcomes of the YONM 2 3.1 Global Level 2 3.1.1 Advocacy 2 3.1.2 Evidence 4 3.1.3 Global Policy Engagement and Action 5 3.2 Global Level by WHO Region 6 3.2.1 African Region 6 3.2.2 Region of the Americas 6 3.2.3 Eastern Mediterranean Region 6 3.2.4 European Region 7 3.2.5 South-East Asia Region 7 3.2.6 Western Pacific Region 7 3.3 Country Level, by Category 8 3.3.1 Recognition and Appreciation 8 3.3.2 Special Events 8 3.3.3 Leadership Advancement 9 3.3.4 Political Engagement 10 3.3.5 Education and Training 10 3.3.6 Employment 11 3.3.7 Service Delivery and Work Environment 12 + 4. Discussion 13 + 5. Conclusion 16 + 6. References 17 iv vExecutive Summary The 72nd World Health Assembly (WHA) designated (WHA72(19)) 2020 The International Year of the Nurse and the Midwife (YONM). This provided a special opportunity to celebrate the two professions and drive investments in the education, employment, leadership and working conditions of the largest component of the health workforce. A rapid review was conducted of online information in English of reported activities and outcomes of the International Year of the Nurse and the Midwife from mid-2019 (when it was announced) through mid-2021 (to capture activities postponed due to the COVID-19 pandemic). The findings, which cannot be considered representative or comprehensive, were described at the global and WHO Regional levels and, at the country-level, they were grouped into special events, high-level recognition and awards, advancements in leadership, and commitments and actual investments in education, employment and working conditions. The YONM was a powerful catalyst for global advocacy, evidence, and policy action. The Nursing Now campaign generated more than 700 grassroots nursing groups in 126 countries. The State of the world’s nursing 2020 and the State of the world’s midwifery 2021 reports provided persuasive data on these two workforces. Shortly thereafter, Member States requested that WHO develop the next Global Strategic Directions for Nursing and Midwifery (SDNM), which were adopted with a Resolution on nursing and midwifery – the first in ten years. The high-profile appreciation and special events during the YONM increased public awareness and provided an avenue through which nurses and midwives could celebrate, and be celebrated for, their contributions to health and well-being. As the YONM took place squarely within the global COVID-19 pandemic, there was added resonance to the recognition of nurses and midwives, but also to the call for support, motivation and protection for all health and care workers to end the COVID-19 crisis. There were several commitments to and investments in nursing and midwifery education, employment and working conditions announced in the YONM period. In each WHO Region, there were examples of countries committing to and creating jobs, including new roles (e.g., midwife, advanced practice nurse) that could help expand service delivery. While actual policy action in and investments by countries can be interpreted as positive outcomes of the YONM, many other commitments to action or investments in these areas are yet to be realized. vi The next steps are to consolidate both the gains and the lessons learned during the YONM, and to each take our respective actions to ensure that announcements are turned into policy decisions, and advocacy appropriately links with political decisions. There is a clear mandate through the SDNM to monitor and hold countries accountable for strengthening their nursing and midwifery workforces via investments in education, jobs, leadership and service delivery. If countries can realize the gains through policies that help countries optimize the contributions of nurses and midwives towards achieving UHC and the SDGs, it will be the longest-lasting legacy of the YONM. 11. Background The World Health Organization’s (WHO) Global Strategy for Human Resources for Health, published in 2016, projected a shortfall of 18 million health workers below the level needed to achieve and sustain the health-related Sustainable Development Goals (SDGs) by 2030. Globally, the nursing and midwifery workforces comprised over 50% of the health workforce. Nurses and midwives provide a huge range of primary health care (PHC) services and, as with all other health and care workers, shortages were greatest in low and lower-middle-income countries. The biggest challenge was to accelerate country, regional, and global-level investments in the health workforce to overcome predicted shortages, especially in countries with the weakest PHC systems and the furthest from achieving universal health coverage (UHC). Investments in these countries were needed to build the necessary foundations for PHC. This included human capital investments in pre-service education, particularly education institutions in rural areas, as well as recurrent investments, such as employment and retention of health workers. Some countries required longer-term development assistance to ensure both adequate fiscal space and strengthened governance of health systems, so that the required health workforce investments could increase universal access to primary health care. Challenges in human resources for health featured prominently at the 72nd World Health Assembly (WHA). The Assembly decided (WHA72(19)) to designate 2020 The International Year of the Nurse and the Midwife (YONM), in part to mark the 200th anniversary of Florence Nightingale’s birth. This formal designation provided a special opportunity to celebrate the two professions and drive investments in them. Nursing and midwifery being the largest component of the health workforce, investments in education, employment, leadership and working conditions could make meaningful progress towards diminishing the shortages of health and care workers and advancing towards UHC and the SDGs for Quality Education, Gender Equality, Decent Work and Inclusive Growth. 2. Methods A rapid review of information available in the public online domain was conducted using Google. The primary search terms were “International Year of the Nurse and the Midwife” AND [each WHO Member State]. A data charting form was developed in Excel to record relevant findings. Items were included on the charting form if they occurred after the designation of the YONM by the 72nd WHA and had an implicit or explicit relationship with the YONM. To complement the online findings, the WHO Regional Offices were asked to share noteworthy activities from 2 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments their perspective, as were the WHO Collaborating Centres for Nursing and Midwifery. These contributions were received via email and added to the data charting form where appropriate. The content on the data form was sorted into distinct categories and then subcategorized as relevant subgroupings were constructed. 3. Outcomes of the YONM 3.1 Global Level The WHO Director-General initiated global action by immediately convening a high-level steering committee of global nursing and midwifery partners, comprised of the International Council of Nurses (ICN), International Confederation of Midwives (ICM), United Nations Population Fund (UNFPA), and Nursing Now global campaign. The committee met seven times during the YONM period (2019–2021) to ensure that YONM celebrations also fuelled advocacy on key issues, a stronger evidence base for decision-making and impactful policy actions. The dawning of the YONM sparked high-level recognition of nurses and midwives throughout the year. The WHO Director-General issued a series of tweets (1) on New Year’s Eve (31 December 2019), and a statement (2) by the United Nations on 1 January 2020 (2) emphasized the purpose of the YONM to advocate for greater investment in nurses and midwives and ensure they can work to their full potential. In his New Year’s address, Pope Francis acknowledged the importance of the Year and praised the work and dedication of nurses and midwives. On World Health Day (7 April), the United Nations Secretary-General expressed his appreciation (3) to nurses and midwives, as did the WHO Director-General and the Executive Director (4) of the UNFPA. 3.1.1 Advocacy Ahead of 2020, the Steering Committee partners reached out to heads of state (5) to encourage them to recognize and leverage the YONM as part of a global “health for all” movement. To highlight the need to invest in nurses and midwives, the WHO maintained a year-long campaign (6), providing online events and engagements on a variety of social media platforms, including a dedicated category in the WHO International Film Festival (7). UNFPA launched a YONM advocacy campaign based on stories on the impact midwives have in a wide variety of settings and held global advocacy events on the importance of midwives in achieving UHC (8), including the contributions and challenges of indigenous midwives (9). UNFPA, ICM and partners issued a Global Call to Action (10) to protect midwives during the COVID-19 pandemic and a podcast series (11) on how midwives promote maternal and newborn health and save lives at birth. 3The ICM capitalized on the YONM to launch their Push Campaign (12), a ten-year movement to position midwives as central to delivering SDG 3.1 (reducing the maternal death rate to 70 per 100 000). They developed key resources including a global interactive digital data repository (13) and advocacy tools (14) to equip midwives’ associations for advocating for increased investments in midwifery. The Stronger Together webinar series (15) highlighted midwives’ perspectives on strengthening and empowering maternal and newborn health services. ICM collaborated with Seed Global Health on the Nurses Lead, Midwives Lead campaign (16), and with the Global Breastfeeding Collective on an advocacy brief (17) about the role of midwives and nurses in protecting, promoting and supporting breastfeeding. Inspired by ICN and in partnership with Jhpiego, ICM inaugurated an international photo contest, Midwives in the Spotlight (18). The ICN launched a website which highlighted and celebrated the work of nurses during 2020, including through a “Nursing in Focus” photo contest and weekly case studies on innovative work by nurses across the world. “Year of the Nurse” coins and certificates were issued for ICN members. On International Nurses Day, the ICN released Nurses: A voice to lead (19), a “call to action” that detailed the contributions of nurses to addressing global health challenges. The ICN also published new Advanced practice nursing guidelines (20), a report on the ageing nursing population, and a dedicated chapter on nursing in the annual report (21) by the Safeguarding Health in Conflict Coalition. In statements (22) to the WHO Executive Board and the World Health Assembly, the ICN called on Member States to leverage the YONM to take action on key nursing policy issues. The activities and outcomes of Members’ campaigns are detailed in the report 2020: The International Year of the Nurse and the Midwife and the COVID-19 pandemic (23). The Nursing Now global campaign, centred on the YONM, aimed to improve health and health care by raising the profile and status of nurses. Nursing Now supported national and institutional organizing for advocacy and action to address key priorities for nursing. By the end of the campaign, there were more than 700 Nursing Now groups in 126 countries. The final report (24) states that “63 groups reported increased investment in nursing during the campaign, with some evidence that in 24 countries investment was directly influenced by local Nursing Now groups”. The ‘Nightingale Challenge’ (which has since been renamed the ‘Nursing Now Challenge’) encouraged employers to offer leadership development opportunities for young nurses and midwives. By the end of 2020, more than 31 000 young nurses and midwives had participated in programmes by over 800 employers in 79 countries. In 2021, the Global Solutions Initiative (25) focused on leveraging nurses’ ideas to address global health issues, and the Nurses Together initiative encouraged nurses to present priorities for investment to their ministers of health. 4 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 3.1.2 Evidence The designation of the YONM and the related global advocacy campaigns catalysed unprecedented engagement in evidence generation to describe the nursing and midwifery workforces. The YONM Steering Committee partners worked sequentially to engage government chief nursing and midwifery officers (GCNMOs), professional associations and unions, Nursing Now groups and other stakeholders, such as regulatory bodies and WHO Collaborating Centres, to transmit national data for the reports on the State of the world’s nursing (SoWN) 2020 (26) and State of the world’s midwifery (SoWMy) 2021 (27). Countries reported their nursing and midwifery workforce data for SoWN 2020 and SoWMy 2021 through National Health Workforce Accounts (NHWA), an online platform and process through which WHO Member States collate, monitor and use their human resources for health data, and share the data with WHO for global compilation and reporting (for example, on SDG 3c) and communication on the NHWA Portal. The SoWN 2020 report was generated by national data from 191 Member States— the highest number for a WHO report on human resources for health and a 53% increase in data points compared to 2018. Each country’s data was transposed into a country profile available on the NHWA portal in WHO official languages. Reports from WHO Collaborating Centres for Nursing and Midwifery indicated that countries such as Lithuania, Japan, Democratic People’s Republic of Korea, Myanmar and the Philippines launched and disseminated the SoWN report through a series of dialogues, webinars and meetings with relevant stakeholders.1 Both Japan and the Democratic People's Republic of Korea translated the SoWN report into the national language for wider uptake2 and a university in the USA incorporated the findings and country profiles into its undergraduate and graduate nursing curricula.3 GCNMOs of the South Pacific and key stakeholders gathered virtually to review their country contexts vis-à-vis the policy options in SoWN 2020 and articulate their recommendations for regional policy changes.4 The SoWMy 2021 report, the third of its kind, included countries in all income categories and presented at least one data element from all 194 WHO Member States (a substantial increase from the 87 countries included in SoWMy 2014). This provides the most comprehensive global data set on midwifery personnel to date and allowed for robust findings on the density, 1 Reports provided by the respective WHO Collaborating Centres for Nursing and Midwifery in a four-week period beginning 23 November 2020. 2 Written communication from the Japan National Centre for Global Health and Medicine and Korean Nurses Association, respectively. 3 Written report provided by the WHO Collaborating Centre at the University of Birmingham School of Nursing, Alabama, USA; 24 November 2020. 4 Written report provided by the WHO Collaborating Centre at University of Technology Sydney, Australia on 27 November 2020. 5distribution, education, leadership and regulation of midwifery personnel around the world. Various international events served to share the evidence base on midwifery, including the Wilson Center’s Advancing the Dialogue Maternal Health Series (28) and a webinar series organized by the Network of WHO Collaborating Centres for Midwifery, featuring research developments in midwifery education, leadership and practice (29). The evidence in the SoWN 2020 and SoWMy 2021 reports was complemented by increases in the peer-reviewed literature on nursing and midwifery. A number of journals issued a call for papers on nursing and midwifery, including the Lancet, Human Resources for Health Online (30), the Journal of Research in Nursing and many others. In Lancet Global Health, a seminal publication updated the analysis on the potential impact of midwives on a global scale in preventing and reducing maternal and neonatal mortality and stillbirths. A study of articles available in PubMed indicates that, even accounting for year-on-year increases in publications, the number of peer-reviewed articles on nursing and midwifery increased in 2020 and 2021. In comparison to the Year of the Nurse in 2010, which marked the 100th anniversary of the death of Florence Nightingale, in the YONM period there was a ten-fold increase in peer-reviewed publications referencing the YONM. 3.1.3 Global Policy Engagement and Action This powerful global advocacy, along with the swelling evidence base, provided a strong foundation for global policy engagement and action. Engagement in 2020 from GCNMOs along with their counterparts in nursing and midwifery associations resulted in the largest ever biennial WHO Global Forum of GCNMOs and the WHO-ICN-ICM Triad Meeting (31). At this meeting, participants reviewed the available evidence and policy options and prioritized areas for strategic focus going forward. Policy action was initiated at the 73rd World Health Assembly (a special session dedicated exclusively to COVID-19) when Her Royal Highness Princess Muna Al-Hussein of Jordan used her keynote address to urge Member States to invest in nurses and midwives. When the 73rd WHA resumed in November 2020, Member States requested that WHO develop the next Global Strategic Directions for Nursing and Midwifery (SDNM) and bring them to the 74th WHA for consideration. The 74th WHA adopted the SDNM 2021–2025 with a Resolution on nursing and midwifery – the first in ten years. The 12 policy priorities in the SDNM 2021–2025 represent a global consensus on how countries can maximize the contributions of nurses and midwives towards population health goals. 6 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 3.2 Global Level by WHO Region 3.2.1 African Region The WHO Regional Office compiled data and information for a regional-level analysis of key nursing and midwifery issues. The World Bank partnered with WHO, Jhpiego, ICN, and East, Central and Southern Africa College of Nursing to develop a sub-Regional report (32) on the nursing education labour market in east, central, and southern Africa using SoWN 2020 data. The Global Nursing Leadership Program (33) was launched by Harvard’s T. H. Chan School of Public Health and the Africa Centres for Disease Control and Prevention to expand the capacities and strengthen the policy role of senior government nursing leaders in the African Region. 3.2.2 Region of the Americas In the Region of the Americas, the YONM catalysed global and national policy leadership. Jamaica initially proposed the Year of the Nurse and the Midwife to fellow WHO Member States at the 144th meeting of the Executive Board. Jamaica then sponsored a WHA Resolution (34) to adopt the draft Global Strategic Directions for Nursing and Midwifery, which was adopted with over 50 countries as co-sponsors. The Bahamas hosted the Nursing Now global campaign board to discuss progress and plan the future of the campaign with Regional leaders (35). The WHO AMR Office convened a large virtual gathering of government chief nursing and midwifery officers to discuss strategic approaches to strengthening the nursing workforce during the YONM following the publication of the SoWN 2020 report, and given the challenges imposed by the COVID-19 pandemic. 3.2.3 Eastern Mediterranean Region In line with the 72nd WHA designation of 2020 as the International Year of the Nurse and the Midwife, the 66th Regional Committee of the Eastern Mediterranean issued a Call to Action to strengthen nursing. The Call urged Member States to focus on key areas in advancing the profession, including the development and implementation of effective human resource and health information systems, maximizing the scope of practice of nurses and supporting country level activities to mark the YONM. In 2020, WHO EMR organized a Region-wide meeting for all GCNMOs, WHO Collaborating Centres for Nursing and Midwifery, regulatory bodies, and professional associations, to take stock of progress on the Call to Action and identify priorities for moving forward. 73.2.4 European Region To showcase the contributions of nurses and midwives during the YONM, WHO EUR rolled out a large-scale social media campaign. Posts on Twitter received more than two million views; Instagram posts reached more than 120 000 people, and Facebook posts reached almost 700 000. Traffic on the EURO Nursing and Midwifery website (36) almost doubled during the Year. A milestone for the YONM in the Region was a WHO EURO-hosted meeting of GCNMOs, WHO Collaborating Centres for Nursing and Midwifery, and professional associations with the purpose of taking stock of progress on the European Strategic Directions for Nursing and Midwifery 2016–2020 and to plan for implementation of the SDNM 2021–2025 (36). WHO EURO launched two major resources during the YONM: the Midwifery Assessment Tool for Education (MATE) on the International Day of the Midwife (37) and the competencies for nurses working in primary health care on International Nurses Day (38). 3.2.5 South-East Asia Region Citing the landmark opportunity of the YONM, the WHO Regional Office for South-East Asia published the Regional Strategic Directions for strengthening midwifery in the South- East Asia Region 2020–2024. (39) A photo competition was also held to highlight the varied roles and contributions of nurses and midwives in the Region (40). The Regional Director’s speech on World Health Day in 2020 called for an enabling work environment, more education opportunities, and more engagement in leadership for nurses and midwives (41). 3.2.6 Western Pacific Region The WHO Regional Office for the Western Pacific published The Vital Roles of Nurses and Midwives in the Western Pacific Region (42) to showcase contributions of nurses and midwives to population health and provide policy directions for strengthening the professions. The Pacific Community and the Department of Foreign Affairs and Trade co-organised the Inaugural Pacific Heads of Nursing meeting (43), which is intended to provide executive level oversight for regional nursing functions in the Pacific, including a policy advisory and technical role. Throughout 2020, the WHO Collaborating Centre at the University of Technology Sydney, Australia (WHO CC UTS), in collaboration with WHO Division of Pacific Technical Support and national Ministries or Departments of Health in the Pacific Islands, carried out a scoping study (44) to provide recommendations, including a roadmap, for improving the quality of nursing and midwifery education and regulations in Pacific Island countries and areas. 8 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 3.3 Country Level, by Category 3.3.1 Recognition and Appreciation In Jamaica, His Excellency the Governor-General of Jamaica launched the Year with a proclamation and assigned a high-level Patron for the national campaign (45). In the Seychelles, the Year was inaugurated by the Minister of Local Government in the presence of the President, National Assembly Speaker, Secreta ry of State for Health, Attorney General and other Ministers (46). The Ministers of Health of Botswana (47) and Lesotho (48) also officiated at national launch proceedings. Many high-level global and national government figures used special days within the YONM to publicly appreciate the work of nurses and midwives. Royal families, presidents, ministers, embassies, and other government officials from countries such as Antigua and Barbuda (49), Australia (50), Bangladesh (51), Cyprus (52), Italy (53), Kyrgyzstan (54), Namibia (55), Qatar (56), Sweden (57), South Africa (58), Uganda (59), the United Kingdom (60), Viet Nam (61) and Zimbabwe (62) used the occasions of International Nurses Day and International Day of the Midwife to publicly praise the work of nurses and midwives. In many instances, the appreciation and recognition took the form of awards for those who have positively impacted the nursing and midwifery professions. Her Royal Highness Princess Muna Al-Hussein of Jordan was awarded (63) the WHO’s Health Leaders Award for Outstanding Leadership in Global Health for her "tireless support over six decades for nurses and midwives". The Minister of Health of Tonga, a nurse and a midwife, was awarded the WHO’s Director General’s Award (64), as was the Kingdom of Tonga's Nurses' Choir, for their inspiring performances during the International Year of the Nurse and the Midwife, including at the 73rd World Health Assembly. Dr Mabel Magowe, Deputy Dean of the Health Sciences Faculty at the University of Botswana, was the first nurse to be awarded the Sheth Distinguished International Alumni Award (65). 3.3.2 Special Events Throughout the year, a variety of creative events helped celebrate, commemorate and raise awareness of the Year. In the United Kingdom, the likeness of Florence Nightingale was projected onto the façades of St Thomas' Hospital (66) and the Houses of Parliament, both in London; in Italy, onto the façade of Spallanzani Hospital in Rome (67). Many countries organized month-long or even year-long campaigns; others had special events such as a national march (68), an “awareness walk” (69), a walk-a-thon (70), a “flash mob” (71), a prayer service (72) or a tree planting ceremony. Both traditional and social media were used to heighten awareness of the role of nurses and midwives in advancing health. In some countries it was a commemorative stamp, poster campaign, messages of support on public transport (73), serial 9newsletters (74), a radio campaign,5 daily TV shows (75), films (76), visits to secondary schools by area nurses (77), Facebook Live events (78), videos (79), webinars (80) or multimedia online platforms. In Bangladesh, an “awareness session” was held with the Health Reporters Forum, to enable reporters to write accurately about nurses and midwives in their coverage of YONM- related events.6 In Malta, a targeted marketing campaign (81) by the nurses’ union and the Ministry of Health aimed to attract young people to the profession. The Indo-Pacific Centre for Health Security dedicated a podcast (82) to the contributions of nurses and midwives to health security. New international conferences were hosted by governments and partners in Iraq (83), Ireland (84), Nigeria (85), and the United Kingdom (86), while recurring conferences in Ireland (87), Jamaica (88), Slovenia (89), Thailand (90) and others used the YONM to emphasise key themes in the conference content. 3.3.3 Leadership Advancement In the period around the YONM, there were significant appointments of nurses and midwives to senior government health and academic positions. In both the Seychelles (91) and Tonga (92), the health professional appointed to be the Minister of Health was both a nurse and midwife. The Minister of Health of Tonga was also elected to the post of Rapporteur on the World Health Organization's Executive Board – the first time for a nurse and a midwife. In Chile, the National Chief Midwife (93) position was re-introduced for the first time since 1834. A Chief Midwife position was established in England (94); it already existed in Scotland (95). The Ministry of Health in Malawi established a high-level position specifically for midwifery in Malawi's central hospitals7 and the Bhutan Ministry of Health announced a dedicated division for nursing and allied health professionals.8 In Myanmar the first Rector position for the University of Nursing was established.9 In Egypt, the Government Chief Nurse was appointed to a high-level Committee on Universal Health Coverage and Health Insurance.10 The Irish delegation to the 73rd WHA selected a nurse to deliver the national statement (96) and a midwife was chosen to lead a strategic and technical advisory group reporting to the WHO Director-General (97) on maternal, newborn, child and adolescent health and nutrition. Efforts were also made to develop the leadership capacity of nurses and midwives during the YONM through leadership development programmes. For instance, the Philippines College of Nursing, together with the Department of Health committed to further UHC leadership training 5 WHO Collaborating Centre report from the University of Pennsylvania, USA. 6 Written communication from WHO Regional Office for South-East Asia. 7 Written communication from WHO Department of Maternal, Child, Adolescent Health and Ageing. 8 Written communication from WHO Regional Office for South-East Asia. 9 WHO Collaborating Centre report from the University of Nursing, Yangon, Myanmar. 10 Written communication from the WHO Representative in Egypt. 10 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments for public health nurses (98). In Samoa, a series of training sessions on Transformational Leadership (99) was conducted for nurses and midwives from the private and public sectors. At three regional hospitals in Croatia, leadership courses (100) were introduced to give young nurses valuable insight into leadership practices as part of the Nightingale Challenge. Employers in the Solomon Island also participated in the Nightingale Challenge and provided leadership development training sessions. The Scottish Government worked with NHS Education for Scotland to deliver senior nursing leadership development training sessions.11 In Jamaica, the Leadership Development Lecture Series (101) was organized to build the leadership capacities of nurses and midwives in the Caribbean. In India, the Ministry of Health and Family Welfare co-developed and launched a 12-week Midwife Leadership Programme pilot course (102) with three midwifery leaders from seven states. 3.3.4 Political Engagement The awareness and visibility created by the YONM may have stimulated a more political posture of nurses and midwives within some countries. In Brazil for instance, nurses were elected (103) to occupy 1 192 seats in Brazilian City Councils and City Halls according to a survey by the Brazilian Federal Council of Nursing and based on data from the Superior Electoral Court. In the USA, a nurse was chosen as one of three electors for Washington, D.C. for the presidential election (104). In Finland, the YONM and SoWN 2020 reports were the backdrop for meetings held with parliamentarians.12 Advocacy efforts were also initiated for expanding the scope of practice for midwives in Myanmar.13 In Uruguay, the Ministry of Public Health created a National Commission (CONAE) to hold a series of intersectoral policy dialogues (105) on how investments in nursing can help achieve national health goals. 3.3.5 Education and Training In the United Kingdom, an increase of funding and enrolment was noted for both nursing and midwifery. In England, 34 190 new nursing students began a nursing degree in 2020, representing a 20% increase compared to 2019 and a record high for undergraduate intake. In Wales (106), the government increased funding for more education places for nurses and midwives and increased the midwifery education intake by 25%. In September 2020, Health Education England allocated £7 million to support nursing associates and assistant practitioners in training to become nurses through a two-year 'top-up' apprenticeship (107). In Scotland, bursaries for nursing and midwifery students were raised to £10 000 per annum (108). 11 WHO Collaborating Center report from Department of Nursing and Community Health, Glasgow Caledonian University. 12 WHO Collaborating Centre report from Hotus Nursing Research Foundation, Finland. 13 WHO Collaborating Centre report from the University of Nursing, Yangon, Myanmar. 11 The Federal Ministry for Family Affairs in Germany, launched a nationwide campaign to attract people to a career in nursing (109). In Finland, nursing and midwifery programmes in universities and colleges received more state funding for students.14 In Ireland, Trinity College Dublin announced a fellowship scheme worth €1 million to enable nurses and midwives to undertake doctoral research (110). The Philippines College of Nursing also secured an increase in government research funding for nurses.15 In Pakistan, the President marked the National Year of Nursing by announcing the establishment of a new nursing university in Islamabad, adjacent to the National Institute of Health, to provide training to 25 000 students each year (111). Advancements in quality assurance mechanisms for education and training were also seen during the YONM. In South Africa, a national push for strengthened education programmes resulted in eight of the ten nursing colleges receiving accreditation by the end of September 2020.16 In Ghana, the first ever policy on preceptorship for midwifery students’ clinical competency was launched.17 New education standards published by the United Kingdom’s Nursing & Midwifery Council will take effect in all universities beginning in 2022.18 In 2019, the Indian Ministry of Health and Family Welfare initiated the first Midwifery Educator and Nurse Practitioners in Midwifery programmes (112) for the country. 3.3.6 Employment The Year of the Nurse and the Midwife and the COVID-19 pandemic underscored the importance of having sufficient numbers of nurses and midwives in health systems. Governments took steps to retain and create additional jobs, and employ or hire nurses and midwives, to meet country specific needs. In Pakistan’s Year of Nursing (2019), the President announced plans to double the size of the nursing sector within two years in an effort to overcome shortages (111). In 2020, the Bangladesh Public Service Commission created 6 000 Senior Staff Nurse posts; recruitment began in 2021.19 In India, there was a commitment to adding 85 000 midwives to the workforce by 2023 (80). In Mexico, the number of midwifery contracts renewed by the government increased compared to the previous five years.20 The United Kingdom and Kenya signed a Health Alliance which provides a route for registered and unemployed nurses 14 WHO Collaborating Centre report from Hotus Nursing Research Foundation, Finland. 15 WHO Collaborating Centre report from University of the Philippines, Manila. 16 National strategic direction for nursing and midwifery education and practice: A roadmap for strengthening nursing and midwifery in South Africa. 17 Reports provided by the respective WHO Collaborating Centres for Nursing and Midwifery. 18 WHO Collaborating Centre report from Chief Nurse Directorate, Public Health England. 19 Written communication from National Professional Officer, Human Resources for Health, WHO Country Office Bangladesh. 20 WHO Collaborating Centre report from Escuela Nacional de Enfermeria y Obstetricia, Universidad Nacional Autónoma de México. 12 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments in Kenya to work in the United Kingdom, before returning to work in Kenya’s health sector (113). In Germany, the Health Care and Care Improvement Act was initiated to create 20 000 additional jobs for nursing assistants from January 2021 (114). As of April 2020, 345 nurses and midwives had been hired in response to Ireland’s call to ease the pressure placed on the professions during the YONM due to the pandemic (115). In Finland, the government committed to increasing funding and providing more positions for advanced nurse practitioners (116). Countries also undertook national planning to ensure service delivery needs could be met by employment strategies for nurses and midwives. Strategic plans were launched in Botswana (117) and South Africa (118), while in the Seychelles, the Department of Health, nursing leaders, and the National Institute of Health and Social Studies were tasked with developing strategies to address nursing and midwifery shortages (119). A similar process was undertaken in Ireland to address shortages, labour disputes, and provide for continued development of career pathways and retention of highly trained professionals (120). An expert review by nursing and midwifery leaders generated recommendations direction for the development of the professions and modernise the approach for workforce planning for the next five years (121). 3.3.7 Service Delivery and Work Environment As part of the Concerted Care Action (Konzertierte Aktion Pflege), the German Government put forth legally binding goals and specific measures for better working conditions, better wages, more training positions and more responsibility for nursing staff (122). Progress on this initiative was driven forward in the context of the YONM and the COVID-19 pandemic. Similarly, the United Kingdom government announced funds to review how community midwifery services can be maintained or strengthened in crisis situations (123). In Northern Ireland, the government commitment was towards enhancing service delivery by ensuring safe staffing levels (124). In Hungary, as part of a government-led campaign to increase its frontline nursing staff, there was a commitment to increasing the wages of Hungarian nurses (125). Health leaders in Lesotho (48), Uganda and Zimbabwe resolved to ensure conducive working environments for nurses and midwives. The Zimbabwean Health Service Board (62) also announced new health insurance and paid sick leave for affected health workers and their families; Bangladesh instituted a similar programme of an honorarium and increased health and life insurance coverage (126). In the Seychelles, the base pay for nurses and midwives was raised as of 1 July 2020 (46). In the Solomon Islands, the Ministry of Health and Medical Services reinforced its commitment to supporting and equipping nurses and midwives for effectively and efficiently providing the services that meet the needs of the population (127). 13 4. Discussion We conducted a rapid review of online information in English of reported activities and outcomes of the International Year of the Nurse and the Midwife from mid-2019 (when it was announced) through mid-2021 (to capture activities postponed due to the COVID-19 pandemic). The findings, which cannot be considered representative or comprehensive, were described at the global and WHO Regional level and, at the country-level, were grouped into special events, high-level recognition and awards, advancements in leadership, and commitments and actual investments in education, employment and working conditions. The activities related to YONM include more than 50 countries from all WHO Regions and all World Bank income level classifications. The YONM was a powerful catalyst for global advocacy campaigns and ambitious agendas for evidence and policy action. Some campaigns that launched in the YONM period, such as Nursing Now, have concluded and assessed their impacts in published reports; others, such as ICM’s PUSH campaign, will last through the SDG era. The designation of the YONM provided a strong impetus for strengthening the evidence base on nursing and midwifery, with several positive outcomes. SoWN 2020 and SoWMy 2021 greatly increased the data available for the period 2013–2018 compared to other occupations due to the momentum created by the YONM (26). Furthermore, the availability of actual and retrospective data made it possible for previous estimates to be updated and the data limitations of prior analyses and reports to be addressed. Finally, the demand for these data triggered an increase in the country-level nominations of NHWA reporting focal points, which helps strengthen national health human resources (HRH) information systems and improves WHO’s ability to collate and share these data through the NHWA portal. The special events held during the YONM increased public awareness and provided an avenue through which nurses and midwives could celebrate, and be celebrated for, their contributions to health and well-being. However, the YONM had almost complete overlap with the COVID-19 pandemic, which exposed chronic underinvestment in the health and care sector, including shortages of health workers, and poor working conditions. As postponed YONM activities were held in 2021, they dovetailed with the International Year of Health and Care Workers (YOHCW) campaign (128), which had a slogan of #ApplauseIsNotEnough. The focus of YOHCW was to invest in all health workers and ensure safe and decent working conditions during and beyond the COVID-19 pandemic. This review found examples of countries investing in the work environment- improving nurse staffing levels, increasing wages, and enhancing health insurance and other protections. Nevertheless, with conservative estimates of COVID-19 deaths among health and care worker currently standing at 115 500 (129) and only one in four 14 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments health workers in Africa being vaccinated (130), there is much work to be done to ensure that the celebrations and recognition translate to safe and decent working conditions for all health and care workers everywhere. The highest government, religious and royal representatives publicly appreciated the work of nurses and midwives during the YONM. This type of endorsement can help raise the profile and elevate the status of nurses and midwives in the eyes of the public. Nursing and midwifery have often been considered “women’s work”, a fact that has contributed to social and economic undervaluing of these professions and the sector. This occupational segregation by gender also underpins the pervasive gender pay gap in the health and care sector. There are indications that occupational segregation by gender is lessening: SoWN 2020 reported a global average of 89% of nurses being female; newer WHO data suggest it is now approximately 85%.21 Leveraging the high-level support voiced in the YONM, continued advocacy and policy action is needed to address and change social norms and stereotypes and move towards gender equality and inclusive employment in the health and care workforce that will value and empower both nurses and midwives. Investments in nursing and midwifery education and employment can be effective vehicles to increase women’s empowerment (131, 132). The YONM saw the appointment of nurses and midwives to senior health and academic positions, as well as investments in leadership development, and engagement in political processes. In the SoWN report, the combination of a senior government chief nurse and national leadership development programmes was associated with a higher prevalence of nursing education standards and workplace regulations. However, only 70% and 50% of countries reported a chief nurse or a chief midwife position, respectively, and in the health sector overall, women hold only 25% of health leadership roles. The SoWN report and the YONM may have prompted engagement in political processes, and some countries saw increasing numbers of nurses and midwives being elected or appointed to public office during the YONM, suggesting potentially greater political influence by nurses and midwives among the populations they serve. However, in most work environments, dedicated policies will need to eliminate barriers that impede nurses and midwives from achieving leadership positions and enable them to apply for and achieve leadership positions equally and on merit. Such policies can help drive progress towards SDG 5 (Gender Equality) and SDG target 5.5: Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life. 21 The SoWN 2020 data on gender (representing data ranging from 2013–2018) was based on 132 countries. The NHWA portal update in January 2021 included 146 countries for which nursing personnel data by gender was available and indicated a global median proportion of female nurses of 85%. 15 There were several commitments to and investments in nursing and midwifery education, employment and working conditions announced in the YONM period. In each WHO Region, there were examples of countries committing to and creating jobs, including new roles (e.g., midwife, advanced practice nurse) that could help expand service delivery. While actual policy action in and investments by countries can be interpreted as positive outcomes of the YONM, many other commitments to action or investments in these areas are yet to be realized. Monitoring implementation of the SDNM 2021–2025 through country-level reporting can help track policy advancements in the areas of education, jobs, leadership and service delivery. WHO Member States actively signalled their support for the SDNM 2021–2025 by adopting it with the first WHA Resolution (WHA74.15) on nursing and midwifery in a decade. This clear global mandate, catalysed by the advocacy and evidence from the YONM, presents an excellent opportunity to hold governments and partners accountable for investments in nursing and midwifery that can strengthen primary health care and advance us towards UHC and other SDGs. Limitations: This description of activities, outcomes and accomplishments of the YONM has several inherent limitations. First, it is by no means exhaustive nor representative of what took place in a given country or Region during the YONM period. The contents of this rapid review are limited to those that were available online and in English or were shared with WHO by a Collaborating Centre for Nursing and Midwifery. Many of the evidence sources identified are not peer reviewed, and are of an “advocacy” nature, which introduces an obvious risk of bias. In addition, most of the actions, events or activities, reports or strategies, and political announcements or commitments, are best categorized as inputs or processes, whose added value lies in being potentially instrumental to actual policy and investment decisions. While many activities or outcomes were expressly linked to the YONM, far from all can be specifically attributed to the YONM. Simultaneously, there is no way to know whether a given result would have come about if it were not for YONM, as the occasion undoubtedly provided a rationale, a compelling context, or traction for action or policy change. 16 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 5. Conclusion The designation of 2020 as the International Year of the Nurse and the Midwife catalysed an unprecedented period of celebration, commemoration, commitments and, ultimately, a World Health Assembly Resolution on advancing nursing and midwifery. Impacts were seen in terms of data availability, uptake of the SoWN and SoWMy reports for development of national strategies for nursing and midwifery, increases in nurses and midwives in senior government posts, and investments in education, jobs, and Decent Work. As the YONM took place squarely within the global COVID-19 pandemic, there was added resonance to the recognition of nurses and midwives, but also to the call for support, motivation and protection for all health and care workers. The next steps are to consolidate both the gains and the lessons learned during the YONM, and to each take our respective actions to ensure that announcements are turned into policy decisions, and advocacy links-up effectively with political decisions. There is a clear mandate through the SDNM to monitor and hold countries accountable for strengthening their nursing and midwifery workforces via investments in education, jobs, leadership and service delivery. If countries can realize the gains through policies that help countries optimize the contributions of nurses and midwives towards achieving UHC and the SDGs, it will be the longest-lasting legacy of the YONM. 17 6. References 1. Adhanom Ghebreyesus T. In 2020, the world needs to do a better job in supporting #healthworkers: paying them, training them, and protecting them. During this year, WHO and our partners will ask countries to #SupportNursesAndMidwives [tweet]; 31 December 2019 (https://twitter.com/ DrTedros/status/1212001964751540224?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed% 7Ctwterm%5E1212001964751540224%7Ctwgr%5E1ca7dd 8ac4027d627d1342d1f4fb5d081f1a454a% 7Ctwcon%5Es1_& ref_url=https%3A%2F%2Fnews.n.org%2Fen%2Fstory%2F2020%2F01%2F105 4531, accessed 1 August 2023). 2. Year of the Nurse and the Midwife highlights ‘backbone’ of health systems. Geneva: UN News; 1 January 2020 (https://news.un.org/en/story/2020/01/1054531, accessed 1 August 2023). 3. Secretary-General's message on World Health Day. Geneva: United Nations; 7 April 2020 (https://www.un.org/sg/en/content/sg/statement/2020-04-07/secretary-generals-message- world-health-day-scroll-down-for-french-version, accessed 1 August 2023). 4. Statement by UNFPA Executive Director Dr. Natalia Kanem on the International Day of the Midwife. Geneva: The United Nations Fund for Population Activities; 5 May 2020 (https://tajikistan.unfpa. org/en/news/statement-unfpa-executive-director-dr-natalia-kanem-international-day-midwife- 5-may-2020-0, accessed 1 August 2023). 5. 2020 Year of the Nurse celebrating nursing and midwifery endorsed by WHO Executive board. Geneva: International Council of Nurses; 31 January 2019 (https://www.icn.ch/news/2020-year- nurse-celebrating-nursing-and-midwifery-endorsed-who-executive-board, accessed 19 March 2022). 6. Year of the Nurse and Midwife 2020. Geneva: World Health Organzation (https://www.who.int/ campaigns/annual-theme/year-of-the-nurse-and-the-midwife-2020, accessed 1 August 2023). 7. Online awards ceremony of the Health for All Film Festival. Geneva: World Health Organization; 12 May 2020 (https://www.who.int/news-room/events/detail/2020/05/12/default-calendar/ the-health-for-all-film-festival, accessed 1 August 2023). 8. The Importance of Midwives in Achieving Universal Health Coverage [video]. Washington, D.C.: Wilson Center, United Nations Population Fund; 6 March 2020 (https://www.youtube.com/ watch?v=G4dLwE2S2Q0, accessed 1 August 2023). 9. Indigenous Midwives. Washington, D.C.: Wilson Center; 22 September 2020 (https://www.wilsoncenter.org/event/indigenous-midwives, accessed 8 March 2022). 18 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 10. Global call to action. The Hague: International Confederation of Midwives; 5 May 2020 (https://internationalmidwives.org/assets/files/news-files/2020/06/calls-to-action12. pdf, accessed 28 July 2023). 11. Sara M. Māori midwives on the power of indigenous birthing practices New Security Beat; 18 December 2020 (https://www.newsecuritybeat.org/2020/12/maori-midwives- power-indigenous-birthing-practices/, accessed 1 August 2023). 12. PUSH Campaign. About Push Campaign (video). The Hague: International Confederation of Midwives (https://www.pushcampaign.org, accessed 19 March 2022). 13. Global Midwives' Hub [online database]. International Confederation of Midwives. The Hague (https://www.globalmidwiveshub.org/, accessed 1 August 2023). 14. Toolkits. The Hague: International, Confederation of Midwives (https://www.internationalmidwives.org/our-work/icm-advocacy/toolkits.html, accessed 1 August 2023). 15. Stronger together: a webinar series by and for midwives and women. The Hague: International Confederation of Midwives. (https://www.internationalmidwives.org/ icm-events/pst-events.html, accessed 28 July 2023). 16. Nurses Lead. Midwives Lead [website]. 2020 International Year of the Nurse and Midwife (https://nursesandmidwiveslead.org/, accessed 1 August 2023). 17. Advocacy brief: The role of midwives and nurses in protecting, promoting and supporting breastfeeding. Geneva and New York: Global Breastfeeding Collective, UNICEF, WHO; July 2021 (https://www.globalbreastfeedingcollective.org/media/1391/file/GBC-advocacy- brief-role-midwives-nurses-protecting-promoting-breastfeeding.pdf, accessed 16 March 2022). 18. Midwives in Focus. Baltimore: jhpiego; 2021 (https://www.jhpiego.org/midwives-in- focus/, accessed 1 August 2023). 19. Nurses: A voice to lead: Nursing the world to Health. Geneva: International Council of Nurses; 2020 (https://www.icnvoicetolead.com/, accessed 1 August 2023). 19 20. Press Release: ICN launches new Advanced Practice Nursing guidelines and calls for increased recognition and support for these roles to help fix fragile healthcare systems. Geneva: International Council of Nurses; 16 April 2020 (https://www.icn.ch/news/ icn-launches-new-advanced-practice-nursing-guidelines-and-calls-increased- recognition-and, accessed 1 August 2023). 21. Health workers at risk: violence against health care. Baltimore: Safeguarding Health in Conflict Coalition; 2021 (https://www.safeguardinghealth.org/sites/shcc/files/ SHCC2020final.pdf, accessed 1 August 23). 22. Update on implementation of resolution WHA73.1 (2020) on the COVID-19 response. Geneva: International Council of Nurses; October 2020 (https://www.icn.ch/sites/ default/files/2023-05/WHO%20EB%20Special%20Session%20on%20COVID%20 -%20Item%203.pdf, accessed 1 August 2023). 23. Williamson L. 2020: The International Year of the Nurse and Midwife and the COVID-19 pandemic [powerpoint presentation]. Geneva: International Council of Nurses (https:// indd.adobe.com/view/f618d9a4-9dee-4aa2-9521-ef1460c491f8, accessed 1 August 2023). 24. Holloway A, Thomson A, Stilwell B, Finch H, Irwin K, Crisp N. Agents of change: the story of the Nursing Now Campaign. London: The Burdett Trust for Nursing; 2021 (https:// www.nursingnow.org/wp-content/uploads/2021/05/Nursing-Now-Final-Report- Executive-Summary.pdf, accessed 1 August 2023). 25. Nursing Now Challenge Global Solutions Initiative. London: NursingNow2020, Burdett Trust for Nursing (https://www.nursingnow.org/wp-content/uploads/2021/07/ NNCGSI-Guidance-document.pdf, accessed 30 July 2023). 26 State of the world’s nursing report 2020. Geneva: World Health Organization; 6 April 2020 (https://www.who.int/publications/i/item/9789240003279, accessed 1 August 2023). 27. The state of the world’s midwifery 2021. New York: United Nations Population Fund; 2021 (https://www.unfpa.org/sites/default/files/pub-pdf/21-038-UNFPA-SoWMy2021- Report-ENv4302_0.pdf, accessed 1 August 2023). 28. Advancing dialogue on maternal health series [online database]. Washington D.C.: The Wilson Center (https://www.wilsoncenter.org/collection/advancing-dialogue- maternal-health-series, accessed 1 August 2023). 20 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 29. WHO Collaborating Centres’ Midwifery Network Webinars; 2020 – 2021. The Hague: International Confedeeration of Midwives (https://www.internationalmidwives. org/icm-events/webinars-for-midwives/who-collaborating-centres%E2%80%99- midwifery-network-webinars-2020-2021.html, accessed 28 July 2023). 30. Thematic Series 2021: Research to support evidence-informed decisions on optimizing the contributions of nursing and midwifery workforces. Human Resources for Health, BioMed Central Ltd.; 2 October 2021 (https://www.biomedcentral.com/collections/ yearnursemidwife, accessed 1 August 2023). 31. 2020 Triad Statement. Geneva: World Health Organization; 28 June 2020 (https://www.who.int/publications/m/item/2020-triad-statement, accessed 1 August 2023). 32. Eastern, Central and Southern African Region. Education and Labor Markets for Nurses: Challenges and Opportunities. Washington D.C.: World Bank Group (https://www.icn.ch/ sites/default/files/inline-files/WBG_ECSA%5B12%5D.pdf, accessed 28 July 2023). 33. Global Nursing Leadership program: nurses transforming global public health. Addis Ababa: African Centers for Disease Control and Prevention; 29 October 2020 (https:// africacdc.org/event/global-nursing-leadership-program-nurses-transforming-global- public-health/, accessed 1 August 2023). 34. Latest News: Resolution to strengthen nursing and midwifery. Jamaica Observer; 26 May 2021 (https://www.jamaicaobserver.com/latest-news/resolution-to-strengthen- nursing-and-midwifery/, accessed 1 August 2023). 35. Nursing Now discusses the future of nursing in the Americas during regional meeting; 26 March 2020 (https://archive.nursingnow.org/nursing-now-discusses-the-future-of- nursing-in-the-americas-during-regional-meeting/, accessed 1 August 2023). 36. Nursing and midwifery [online database]. Copenhagen: World Health Organization Regional Office for Europe (https://www.who.int/europe/health-topics/ nursing#tab=tab_1, accessed 27 March 2022). 37. Europe WHOROf. Midwifery assessment tool for education (MATE). Copenhagen: World Health Organization Regional Office for Europe; 2020 (https://www.who.int/europe/ publications/i/item/WHO-EURO-2020-5577-45342-64887, accessed 27 March 2022). 21 38. Competencies for nurses working in primary health care. Copenhagen: World Health Organization Regional Office for Europe; 2020 (https://apps.who.int/iris/ bitstream/handle/10665/365607/WHO-EURO-2020-6958-46724-68019-eng. pdf?sequence=1&isAllowed=y, accessed 28 July 2023). 39. Regional Strategic Directions for strengthening midwifery in the South-East Asia Region 2020 – 2024. New Delhi: World Health Organization Regional Office for South-East Asia; 2020 (https://apps.who.int/iris/handle/10665/331694. accessed 19 March 2022). 40. World Health Day photo competition - 'We thank you'. New Delhi: World Health Organization Regional Office for South-East Asia (https://www.who.int/southeastasia/ news/events/world-health-day/world-health-day-2020/photo-competition---world- health-day-2020, accessed 1 August 2023). 41. Singh P.K. World Health Day 2020. New Delhi: WHO South-East Asia Region; 7 April 2020 (https://www.who.int/southeastasia/news/speeches/detail/world-health-day-2020, accessed 1 August 2023). 42. Vital role of nurses and midwives in the Western Pacific Region. Manila: World Health Organization Western Pacific Region; 2020 (https://apps.who.int/iris/bitstream/handle /10665/333042/9789290619185-eng.pdf?sequence=1&isAllowed=y, accessed 1 August 2023). 43. The Inaugural Pacific Heads of Nursing Meeting. Sydney: UTS World Health Organization (WHO) Collaborating Centre for Nursing, Midwifery and Health Development; 25 February 2020 (https://www.uts.edu.au/research-and-teaching/our-research/ who-collaborating-centre/news/inaugural-pacific-heads-nursing-meeting, accessed 1 August 2023). 44. Scoping study: nursing and midwifery in the Pacific islands. Sydney: UTS World Health Organization (WHO) Collaborating Centre for Nursing, Midwifery and Health Development; 21 May 2020 (https://www.uts.edu.au/research-and-teaching/ our-research/who-collaborating-centre/news/scoping-study-nursing-and-midwifery- pacific-islands, accessed August 1, 2023). 45. Press Release: Jamaica to celebrate Int’l Year of the Nurse and Midwife. Kingston: Ministry of Health and Wellness, Government of Jamaica; 11 February 2020 (https://www.moh.gov.jm/jamaica-to-celebrate-intl-year-of-the-nurse-and-midwife/, accessed 1 August 2023). 22 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 46. Pointe E. International Year of Nurses and Midwives. Seychelles Nation, Health. 22 February 2020 (https://www.nation.sc/articles/3585/international-year-of-nurses- and-midwives, accessed 17 March 2022). 47. Baoki. 2020: The Year of the Nurse and Midwife--Botswana Nurses Union (BONU) is officially launching this year as a year set apart to celebrate the nursing and midwifery fratinity. (https://fb.watch/6pvt4XCE8S/, accessed 1 August 2023). 48. The Launch of the International Year of the Nurse and Midwife Maseru, Lesotho. Brazzaville: WHO Regional Office for Africa; 4 March 2020 (https://www.afro.who.int/ news/launch-international-year-nurse-and-midwife-maseru-lesotho, accessed 1 August 2023). 49. Smith M. International Nurses Day May 12, 2020. St. John’s: Ministry of Health and the Environment, Antigua and Barbuda; 12 May 2020 (https://m.facebook.com/ investingforwellness/posts/912251582548150/?refsrc=deprecated&_rdr, accessed 28 July 2023). 50. Welcome to 2020 – International Year of the Nurse and the Midwife – A message from the Chief Nursing and Midwifery Officer [video]. New South Wales Health; 16 February 2020 (https://youtu.be/LSQen8u-RLs, accessed 1 August 2023). 51. Prime Minister’s message on the International Year of the Nurse and the Midwife for celebrating the 200th birth anniversary of Florence Nightingale. Dhaka: Bangladesh National Portal; 4 May 2020 (http://www.pressinform.gov.bd/site/allnotes/be1b13ff- acd8-41d6-84e0-969f64bdf08f, accessed 30 July 2023). 52. Cyprus President expresses “deep gratitude” to nurses and midwives. Cypress News Agency; 12 May 2020 (https://www.lovecyprus.com.cy/deep-gratitude-to-nurses-and- midwives/, accessed 1 August 2023). 53. International Nurses Day takes place May 12. Italy: Ministry of Health, News; 12 May 2020 (https://www.salute.gov.it/portale/nuovocoronavirus/dettaglioNotizieNuovo Coronavirus.jsp?lingua=english&menu=notizie&p=dalministero&id=4725, accessed 1 August 2023). 54. International Year of the Nurse and the Midwife. Embassy of Switzerland in The Kyrgz Republic [Facebook post]; 11 May 2020 (https://m.facebook.com/story.php?story_fbid=2 54093008999280&id=255768704471192&_rdr, accessed 1 August 2023). 23 55. Namibia celebrates International Day of Nurses. NBC-a Namibian public broadcase service [video]; 12 May 2020 (https://youtu.be/GDC1m1h7M0o, accessed 1 August 2023). 56. jomama88. University of Calgary in Qatar welcomes ‘2020 International Year of the Nurse and Midwife’. I love Qatar.net [newsletter]; 2 May 2020 (https://www. iloveqatar.net/news/healthWellness/university-of-calgary-in-qatar-welcomes- 2020-international-year-of-the-nurse-and-midwife-declaration-from-world-health- organization-1, accessed 1 August 2023). 57. Queen Silvia Nursing Award 2020 [video]. Swedish Care International; 23 December 2020 (https://www.youtube.com/watch?v=8e4ajm-pCSo, accessed August 3, 2023). 58. Address by the Minister for the celebration of the International Year of the Nurse at King Edward Hospital. South African Government [website]; 12 May 2020 (https://www.gov. za/speeches/minister-zweli-mkhize-international-year-nurse-and-midwives-2020- 12-may-2020-0000, accessed 1 August 2023). 59. Ministerial Press Statement on the International Day of the Midwife. Ministry of Health, Government of Uganda [website]; 5 May 2020 (https://www.health.go.ug/cause/ ministerial-press-statement-on-the-international-day-of-the-midwife/, accessed 1 August 2023). 60. An Open Letter from The Duchess of Cambridge to Midwives. The Royal Family [website] (https://www.royal.uk/open-letter-duchess-cambridge-midwives, accessed 1 August 2023). 61. Ceremony honours role of nurses, midwives in pandemic combat. Vietnam Plus-Vietnam News Agency; 12 May 2020 (https://en.vietnamplus.vn/ceremony-honours-role-of- nurses-midwives-in-pandemic-combat/173209.vnp, accessed July 28, 2023). 62. Tsimba T. Zim Acknowledges 2020 as the international year for nurses. Harare Post, Local News; 9 January 2020 (https://www.hararepost.co.zw/en/the-news/local- news/3498-zim-acknowledges-2020-as-the-international-year-for-nurses, accessed 28 July 2023). 63. Director General’s Award for Her Royal Highness Princess Muna Al-Hussein of Jordan and the Tongan Nurse Choir. World Health Organization-Newsroom; 9 November 2020 (https://www.who.int/news-room/feature-stories/detail/director-general-s-award- for-her-royal-highness-princess-muna-al-hussein-of-jordan-and-the-tonga-nurse- choir, accessed 1 August 2023). 24 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 64. Press Release: WHO Director General’s Award Tonga Health Minister and Tongan Nurse Choir. Loop Your News Now: Tonga; 10 November 2020 (https://www.looptonga.com/ tonga-news/who-director-general%E2%80%99s-award-tonga-health-minister-and- tongan-nurses-choir-95639, accessed 1 August 2023). 65. Celebrating women Dr Magowe. Facebook: BWGovernment; June 24, 2020 (https://www. facebook.com/U.S.EmbassyGaborone/posts/we-are-proud-of-the-fulbright-program- alumni-dr-mabel-k-m-magowe-who-continues-t/10158418229275359/, accessed 1 August 2023). 66. Mitchell G. United Kingdom and Italy hold joint ceremony for Nightingale bicentenary. Nursing Times; 13 May 2020 (https://www.nursingtimes.net/news/2020-international- year-of-thr-nurse-and-midwife/uk-and-italy-hold-joint-ceremony-for-nightingale- bicentenary-13-05-2020/, accessed 28 July 2023). 67. United Kingdom and Italy remember Nightingale and honour nurses. The Italian Insider,Newsdesk; 13 May 2020 (http://www.italianinsider.it/?q=node/9219, accessed July 28, 2023). 68. Susu A. Nurses and midwives march to commemorate annual day. The Fiji Times, Local News; 31 January 2020 (https://www.fijitimes.com/nurses-and-midwives-march-to- commemorate-annual-day/, accessed July 28, 2023). 69. Lagos Nurses Flag off 2020 Year of the Nurse & Midwife [video]. PharmaNews; 17 January 2020 (https://youtu.be/Rpjry8m226k, accessed 1 August 2023). 70. Belize celebrates Nurses Week 2020. Belmopan: Government of Belize Press Office; 8 May 2020 (https://www.pressoffice.gov.bz/belize-celebrates-nurses-week-2020/, accessed July 28, 2023). 71. Morgen in Graz: Tanz-Flashmob für Pflege-Berufe. Die Kleine Zeitung. 14 October 2020 (https://www.kleinezeitung.at/service/topeasy/lebenshilfe/5882115/Leichte-Sprache_ Morgen-in-Graz_TanzFlashmob-fuer-PflegeBerufe, accessed July 28, 2023). 72. 2020 ‘Year of the Nurse and Midwife” –The greeting of Pope Francis at the Angelus. Vatican City: The Dicastery for promoting integral human development: News; 20 January 2020 (https://www.humandevelopment.va/en/news/2020/2020-anno-dell- infermiere-e-dell-ostetrica-l-augurio-di-papa-fra.html, accessed August 1, 2023). 73. “We Welcome You!” – New Bus Ad Causes Controversy. Reykjavik: The Reykjavik Grapevine—News; 2 July 2020 (https://grapevine.is/news/2020/07/02/we-welcome- 25 you-new-bus-ad-causes-controversy/, accessed 28 July 2023). 74. Gemeinsam Gesundheit gestalten-- Eine Initiative des Instituts für Pflegewissenschaft und –praxis zum Weltjahr der Pflege [Blog]. Paracelsus Medizenische Universitat; 2 January 2020 (https://weltjahr-der-pflege.pmu.ac.at/, accessed 1 August 2023). 75. Mutoni F. International Nurses and Midwives Day. Kigali: Rwanda Nurses and Midwives Union; 19 September 2020 (https://rnmu.rw/international-nurses-and-midwives- day-2020/#:~:text=2020%20was%20a%20year%20designated,challenges%20 brought%20by%20COVID%2019, accessed August 1, 2023). 76. Nurses making a difference [video]. Birmingham: University of Alabama; 26 February 2020 (https://www.youtube.com/watch?v=ASiv6Jkr1oM, accessed 28 July 2023). 77. Bahamas Information Services. Nurses take to the streets in celebratory march for Nurses Month. The Government of the Bahamas [website]; 1 May 2017 (https:// www.bahamas.gov.bs/wps/portal/public/gov/government/news/nurses%20 take%20to%20the%20streets%20in%20celebratory%20march%20for%20 nurses%20month/!ut/p/b1/vZPJbqNAEIafJQ-Q0IDZjs1qs5umAXNBGGwwi8HG BsPTjyNFGs1IyVwmqTq19Hd96q9VRExERHxOx1OR3k7dOW3ezzGb0ECzIFzxFq- yEGwwrdKMAWltSz4Du2cAfFIQ_Hlf8wMANiSAHiK3wKFJIiQic0eLcreZFMVLYsRny Bu3kpIlcGbaFOewQyGXrh7JnrL4BS-zPrza-2LR5WbMsFsLNMWXOnDm-cI3eqoAuo qNgzTksMFor4kqk9umqlw1nxGboQhrvYP9dddIE4rLOTHKM8JDbglSwgsHczNc-c4- e07B9gJvpLQn50DLdpUbKOTl7jOMQB_v7QUnYvYY3SHk4Y0-uOzjeLvK6-7DxxcP_ofPkIi_ VkZ9BL5Qbq-79kDsnjHuszk8xxE-EYFVgqq53yz14lXcdvIBqaNKNUBNGjbmsO2rG9uW SFuGM6gC3a4L4FeqPfie4eeRmwceFqGME3tw_gY6lC88gRLJGpgBSKO_G6gxDv-Uyfk uZKinCPangcx3ATXH2krvSn3xXSm9XkPWpB2F_Gng__9DnYhP-_Ztyto38MasyOd- kZTAUhzFkRwR9Jjl9oM1ye4UmGVfpRkXul5SxKemK3epgi46tPpoER7YOAIJ- udsRVv3MamcWEgH0-ymR3NdAj3SyVV6ai7bW_7qrCU40Tcya9XZorp2nyR15vJsbTb JYcRRVvh9rtYh7IBW9DkSQ0W6rJ3TuMP6NpL3k14NCir0GrW1OCppPijVAasqwi2lnovFR kw9PrjzlN-o0tUjZxrKNjpl88DkJRrYO5-bATlTQjsmHIOP7eo4Po5nWwYvRN_i0WQ93j7- bgu-vPwCY4o__A!!/dl4/d5/L2dBISEvZ0FBIS9nQSEh/, accessed August 1, 2023). 78. Penn Nursing. Now more than ever: nurses take the lead. Facebook Live; 8 May 2020 (https://www.facebook.com/PennNursing/videos/now-more-than-ever-nurses-take- the-lead/297949867865567/, accessed 28 July 2023). 79. World Health Day, Bangladesh supports nurses and midwives [video]. World Health Organization South-East Asia Region; 10 April 2020 (https://www.youtube.com/ watch?v=Su0EmGFAPpk, access 28 July 2023). 26 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 80. Saluja D, Mayra K. The unimaginable ‘Year of the Nurse and the Midwife 2020’- A reflection from India! [blog]. Antwerp: International Health Policies; 7 January 2021 (https://www.internationalhealthpolicies.org/featured-article/the-unimaginable-year- of-the-nurse-and-the-midwife-2020-a-reflection-from-india/, accessed 28 July 2023). 81. Pace P. Celebrating International Nurses Day 2020 Press Release. Malta Union of Midwives and Nurses [website]; 12 May 20 (https://www.mumn.org/news/celebrating- international-nurses-day-2020-press-release/, accessed 1 August 2023). 82. Iro E, Rumsey M. The International Year of the Nurse and Midwife, Season 1, Episode 10 [podcast]. Contain This: Indo-Pacific Center for Health Security; 13 July 2020 (https:// containthis.buzzsprout.com/620797/4545578-the-international-year-of-the-nurse- and-midwife, accessed 28 July 2023). 83. First International Nursing Conference in Kurdistan Region. Duhok: American Univeristy of Kurdistan [website]; 11 July 2021 (https://auk.edu.krd/first-international-nursing- conference-in-kurdistan-region/, accessed August 1, 2023). 84. Celebrating the International Year of the Nurse and Midwife—WHO. Nursing and Midwifery Board of Ireland; August 2020 (https://nmbi.newsweaver.ie/ Newsletter/7zxh0ybm85w, accessed 1 August 2023). 85. Yusef I. A call to invest in nurses to achieve universal health coverage in Nigeria. Nigeria Health Watch; 14 May 2020 (https://articles.nigeriahealthwatch. com/?s=year+of+the+nurse+2020, accessed 1 August 2023). 86. #Nightingale2020 Conference; [video]. Florence Nightengale Foundation; 27 October 2020 (https://www.youtube.com/playlist?list=PLPX_uY_ hpmOKouLuvc58EPvTfrBrbzcyH, accessed 1 August 2023). 87. INMO Annual General Meeting: Courage to Care [livestream]. NarrowCast Media; 9 October 2020 (https://www.narrowcastmedia.co.uk/inmo-agm-2020/1272/, accessed 1 August 2023). 88. The COVID-19 Experience: Adjusting to the new Normal. National health research conference 202. Kingston: Ministry of Health and Wellness; 19 - 20 November 2020 (https://www.moh.gov.jm/national-health-research-conference-2020/, accessed 28 July 2023). 27 89. Angela Boskin Faculty of Health Care. 13th International scientific conference – International year of the nurse and midwife – 4 June 2020, Bled, Slovenia. Association of Schools of Public Health in the European Region [website]; 7 February 2020 (https://www.aspher.org/articles,4,53.html, accessed 1 August 2023). 90. International conference: N-nergizing Nursing Profession for NCD Challenges (N3 nursing conference). Bangkok: Mahidol University Faculty of Nursing; 8 - 10 January 2020 (https://ns.mahidol.ac.th/ncd2020/index.html, accessed 1 August 2023). 91. Minister Vidot welcomed as Minister for Health. Ministry of Health, Republic of Seychelles [website]; 6 November 2020 (http://www.health.gov.sc/index. php/2020/11/08/minister-vidot-welcomed-as-minister-for-health/, accessed 28 July 2023). 92. Prime Minister announces new cabinet ministers. Government of Tonga, Media Release; 10 October 2019 (https://pmo.gov.to/index.php/2019/10/10/prime-minister-announces- new-cabinet-ministers/, accessed 1 August 2023). 93. Chile establishes national chief midwife position. Hague: International Confederation of Midwives; 2 September 2020 (https://www.internationalmidwives.org/icm-news/chile- establishes-national-chief-midwife-position.html#:~:text=On%20August%2031%20 st%2C%20as%20part%20of%20Latin,and%20hundreds%20of%20midwives%20 and%20other%20healthcare%20practitioners, accessed 1 August 2023). 94. Chief Midwifery Officer. NHS75-England [website]; March 2019 (https://www.england. nhs.uk/nursingmidwifery/chief-midwifery-officer/, accessed 28 July 2023). 95. Howarth G. New Chief Midwifery Officer for Scotland announced. Nursing Times; 12 November 2021 (https://www.nursingtimes.net/news/leadership-news/new-chief- midwifery-officer-for-scotland-announced-12-11-2021/, accessed 1 August 2023). 96. Greene, Karen (greenekaren06). An enormous privilege today in the WHO international year of the Nurse and Midwife to deliver our national statement on behalf of the Irish delegation to the 73rd World Health Assembly [tweet]; 10 November 2020 (https:// twitter.com/greenekaren06/status/1326284757517340672?lang=en, accessed 1 August 2023). 97. Strategic and Technical Advisory Group of Experts. Creating the Strategic and Technical Advisory Group of Experts (STAGE) to advance maternal, newborn, child, adolescent health and nutrition: a new approach. BMJ Global Health. 2021. (https://gh.bmj.com/ content/6/7/e006726, accessed 28 July 2023). 28 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 98. Nursing UP College of Nursing. Heads up to all public health nurses; 28 September 2019 (https://m.facebook.com/story.php?story_fbid=2467798790145765&id=1438189473 106707, accessed 1 August 2023). 99. Nurses and midwives undergo Transformational Leadership training, Samoa: United Nations Development Program [website]; 14 July 2020 (https://www.ws.undp.org/ content/samoa/en/home/presscenter/pressreleases/2020/nurses-and-midwives- undergo-transformational-leadership-training.html#:~:text=%E2%80%9CThe%20 implementation%20of%20the%20four,the%20provision%20of%2, accessed 1 August 2023). 100. Nursing now. Croatia: launching the Nightingale Challenge and navigating COVID-19. NursingNow [website]; 7 July 2020 (https://archive.nursingnow.org/croatia-launching- the-nightingale-challenge-and-navigating-covid-19/, accessed 1 August 2023). 101. PAHO Virtual Course ‘Nursing and Midwifery Leadership: Empowering Nurses – Jamaica – 2020, Pan American Health Organization, Virtual Campus for Public Health [website]; 30 November, 2020. (https://www.paho.org/en/events/launch-paho-virtual- training-nursing-and-midwifery-leadership, accessed 1 August 2023). 102. Meet the first batch of midwifery leadership graduates. World Health Organization. New Delhi: World Health Organization South-East Asia; 8 July 2021 (https://www.who. int/india/news/detail/08-07-2021-meet-the-first-batch-of-midwifery-leadership- graduates, accessed 1 August 2023). 103. Grandin F. Na eleição da pandemia, cai o número de médicos eleitos em 2020. 26 November 2020 (https://g1.globo.com/politica/eleicoes/2020/eleicao-em- numeros/noticia/2020/11/26/na-eleicao-da-pandemia-cai-o-numero-de-medicos- eleitos-em-2020.ghtml, accessed 1 August 2023). 104. Press Release: DC Democratic Party Announces Selection of Presidential Electors. Washington D.C.: The DC Line; 3 September 2020 (https://thedcline.org/2020/09/03/ press-release-dc-democratic-party-announces-selection-of-presidential-electors/, accessed 1 August 2023). 105. Día Internacional de la Enfermería – Lanzamiento del Diálogo Político de Enfermería. Ministry of Public Health, Government of Uruguay [website] ; 12 May 2021 (https://www. gub.uy/ministerio-salud-publica/comunicacion/noticias/dia-internacional-enfermeria- lanzamiento-del-dialogo-politico-enfermeria, accessed 1 August 2023). 29 106. Major expansion in training places for nurses and other health professionals. Welsh Labour [website]; 12 November 2019 (https://www.welshlabour.wales/major- expansion-in-training-places-for-nurses-and-other-health-professionals/, accessed 1 August 2023). 107. Funding boost for nursing apprenticeships.NHS: Health Education England [website]; 11 September 2020 (https://www.hee.nhs.uk/news-blogs-events/news/funding-boost- nursing-apprenticeships, accessed 1 August 2023). 108. Nursing and midwifery stduent support: 2021-2022. Chief Nursing Officer Directorate, Scottish Government; 26 April 2021 (https://www.gov.scot/publications/support- nursing-midwifery-students-scotland-2021-2022/pages/4/, accessed 1 August 2023). 109. von Schwanenflügel M. Concerted action for nursing: Germany's strategy to combat the shortage of nursing professionals. The Journal, AARP International; 1 December 2021 (https://www.aarpinternational.org/the-journal/current-edition/journal-articles- blog/2021/12/atj2021-schwanenflugel, accessed 28 July 2023). 110. To celebrate WHO (World Health Organization) International Year of the Nurse and Midwife, Trinity College Dublin has announced a fellowship scheme worth € 1 million to allow nurses and midwives to undertake doctoral research. Trinity College Dublin Global: Facebook; 6 March 2020 (https://m.facebook.com/tcdglobalrelations%20/ posts/2815470051869958:0, accessed 1 August 2023). 111. Web Desk. President declares 2019 as year of nursing. The News International (Pakistan); 8 January 2019 (https://www.thenews.com.pk/latest/416268-president-declares-2019- as-year-of-nursing, accessed 1 August 2023). 112. First National Midwifery Training Institute inaugurated at Kasturba Nursing College, Mahatma Gandhi Institute of Medical Sciences [website]; 28 May 2022 (https://www. mgims.ac.in/index.php/component/easyblog/498-first-national-midwifery-training- institute-started-at-mgims,-sevagram?Itemid=1, accessed 1 August 2023). 113. Kenya and the United Kingdom sign two key health agreements in London. Citizen Digital News—Kenya; 29 July 2021 (https://www.citizen.digital/news/kenya-and-the- uk-sign-two-key-health-agreements-in-london-12952826, accessed 1 August 2023). 114. Gesundheitsversorgungs- und Pflegeverbesserungsgesetz (GPVG). Ministry of Health, Federal Republic of Germany [website]; January 2021 (https://www. bundesgesundheitsministerium.de/versorgungsverbesserungsgesetz.html, accessed 1 August 2023). 30 The International Year of the Nurse and the Midwife: taking stock of outcomes and commitments 115. Ward M. Nurses on coping during Covid-19, Ahead of Internal Day of the Nurse and Midwife. The Irish Times-Health; 9 May 2020 (https://www.irishtimes.com/life-and- style/health-family/the-year-of-the-nurse-we-re-drained-we-re-stressed-but-we- will-keep-going-1.4236968, accessed 1 August 2023). 116. New roles for nurses – Quality to future social welfare and health care services. Finish Nurses Association [Report]; 2020 (https://sairaanhoitajat.fi/wp-content/ uploads/2020/01/new-roles-for-nurses.pdf, accessed 1 August 2023). 117. Own Correspondent. Botswana poised to celebrate contribution of nurses. The Tswana Times. 12 February 2020 (http://www.thetswanatimes.co.bw/index.php/92-home/765- botswana-poised-to-celebrate-contribution-of-nurses, accessed 1 August 2023). 118. National Strategic Direction for Nursing and Midwifery Education and Practice: A roadmap for strengthening Nursing and Midwifery in South Africa (2020/21-2025/26). Department of Health, Republic of South Africa [website]; March 2020 (https://www. health.gov.za/wp-content/uploads/2022/02/Nursing-Midwife-National-Strategic- Direction-2020-2021-to-2025-2026-Com.pdf, accessed 1 August 2023). 119. Strategic plan for nurses, midwives being finalized. Seychelles Nation – Domestic [website]; September 2019 (https://nation.sc/articles/1524/strategic-plan-for-nurses- midwives-being-finalised, accessed 1 August 2023). 120. Fleming, P., Thomas, S., Williams, D. et al. Implications for health system reform, workforce recovery and rebuilding in the context of the Great Recession and COVID-19: a case study of workforce trends in Ireland 2008–2021. Hum Resour Health 20, 48 (2022). (https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-022- 00747-8, accessed 1 August 2023). 121. Report of the Expert Review Body on Nursing and Midwifery. Dublin: Ireland Department of Health; 29 March 2022 (https://www.gov.ie/en/publication/32783-report-of-the- expert-review-body-on-nursing-and-midwifery/, accessed 1 August 2023). 122. Konzertierte Aktion Pflege legt Umsetzungsbericht vor--Mehr Ausbildung, mehr Personal, mehr Geld. Bundesministerium fur Gesundheit [website]; 13 November 2020 (https://www.bundesgesundheitsministerium.de/presse/pressemitteilungen/2020/4- quartal/kap-umsetzungsbericht.html, accesed 1 August 2023). 123. ASPIRE-COVID-19: Achieving Safe and Personalised maternity care In Response to Epidemics. United Kingdom Research and Innovation [website] (https://gtr.ukri.org/ projects?ref=ES%2FV004581%2F1#/tabOverview, accessed 1 August 2023). 31 124. Health Minister launches International Year of the Nurse and the Midwife. Northern Ireland Executive [website]; 16 January 2020 (https://www.northernireland.gov.uk/ node/42174, accessed 1 August 2023). 125. Stewart H. 2020 is the WHO's Year of the Nurse and Midwife. It's time policymakers listened to them. EuroNews. 10 January 2020 (https://www.euronews. com/2020/01/10/2020-is-the-who-s-year-of-the-nurse-and-midwife-it-s-time- policymakers-listened-view, accessed 1 August 2023). 126. Arif I, Maksudul Karim, Mohammad, Rahman, Siddikur, Hamid A et al. How government rseponse to COVID-19 in Bangladesh? An overview. Journal of Business Strategy Finance and Management. 2021;3:92-102. (https://jbsfm.org/pdf/vol3no1/JBSFM_Vol3_ No1-2_p_92-102.pdf, accessed 1 August 2023). 127. Press Release: World Health Day April 7: celebrating our nurses & midwives. Ministry of Health and Medical Services, Soloman Islands Government. 7 April 2020 (https:// solomons.gov.sb/wp-content/uploads/2020/04/World-Health-Day-Media-release-. pdf, accessed 1 August 2023). 128. Year of Health and Care Workers 2021 [online database]. Geneva: World Health Organization; 20 October 2021 (https://www.who.int/campaigns/annual-theme/year- of-health-and-care-workers-2021, accessed 1-August 2023). 129. Health and health care worker deaths during COVID-19. Geneva: World Health Organization; 20 October 2021 (https://www.who.int/news/item/20-10-2021-health- and-care-worker-deaths-during-covid-19, accessed 1 August 2023). 130. Opening remarks by Dr Tedros Adhanom Ghebreyesus, Director-General. World Health Assembly, Second Special Session, Agenda Item 1.1; 29 November 2021 (https://apps. who.int/gb/ebwha/pdf_files/WHASSA2/SSA2_5-en.pdf, accessed 1 August 2023). 131. Brownie S, Wahedna AH, Crisp N. Nursing as a pathway to women's empowerment and intergenerational mobility. J Clin Nurs. 2018;27:4050-7. doi: 10.1111/jocn.14540. (https:// onlinelibrary.wiley.com/doi/abs/10.1111/jocn.14540, accessed 1 August 2023). 132. Krubiner CB, Salmon M, Synowiec C, Lagomarsino G. Investing in nursing and midwifery enterprise: Empowering women and strengthening health systems--A landscaping study of innovations in low- and middle-income countries. Nurs Outlook. 2016;64:17-23. doi: 10.1016/j.outlook.2015.10.007 (https://www.sciencedirect.com/science/article/abs/pii/ S0029655415003115, accessed 1 August 2023).