June 10, 2021
By: Francis F.M.Harding
As Professor Sheila Tlou once said “Nurses around the world have influence! It’s time to use this influence to persuade governments to invest in jobs, education, and leadership of nurses everywhere. Without nurses, there will be no healthy recovery from the COVID-19 pandemic.” Nurses and midwives play a central role in enhancing essential primary health care across Sierra Leone.
The Universal Health Coverage (UHC 2030) underscores the contribution of nurses towards the Universal Health Coverage in the run-up to achieving Sustainable Development Goals (SDGs).
The provision of equitable access to quality and affordable health care for all under financial hardship to achieve Universal Health Coverage, as defined in target 3.8 of the Sustainable Development Goals, is now a national priority for many low-and middle-income countries such as Sierra Leone.
Sierra Leone like many other countries, nurses/midwives are the first line professional contact with patients who are the only health professionals seen by patient in primary health care facilities.
The work of nurses and midwives appears well cut out, ranging from supporting and managing patients treatment, assisting in surgical processes and taking care of the injured and in fact they go beyond taking care of ill patients, they provides care for families and communities. The training curriculum prepares nurses and midwives well to handle many of the health-related challenges.
The non-health related aspects are well learned with experience under the supervision of their experienced seniors in their work environment. Learning from seniors is premised on an organized system with a seamless flow of roles and responsibilities.
They face many challenges stemming from glaring gaps which could be health aspects such as shortage of workers against the workload, inadequate equipment, leadership and financial constraints.
Nurses and midwives working in the community face more challenges arising from the demand side of care mainly from grappling with community expectations amidst structural barriers.
This cadre, therefore, jiggles between huge tasks that are interlinked with many relations both professionally and personally.
In a BBC interview, a nurse described her typical day as, “a lot harder… it is really tough, feeling you are not doing a brilliant job all the time.”
I believe this is an account for many other nurses and midwives who continue to encounter frustrations and risks such as physical injuries, psychological risks and many more risks. Nurses/midwives have further experienced violence and trauma in the line of work, as most of them don’t want to come out and talk as they afraid of losing their job.
While some risks arise from the nature of work, the risks have been exacerbated by mutable factors as was evidenced during the Ebola pandemic in Sierra Leone. Health workers were infected largely due to deficiencies in infection and prevention control measures as cited by the World Health Organization Ebola infection report.
The report states that 50% of the infected health care workers during the Ebola crisis were nurses. While acknowledging the existing risks, the question remains: How do we take care of our caregivers to keep them safe and motivated as they provide quality health care? In 2020 it was designated as the year of Nurse and Midwives, the World Health Assemble gives them the opportunity to not only recognize and celebrate nurses/midwives but also the opportunity to address the challenges limiting these front line caregivers.
Speaking at the International Council of Nurses Congress, Dr. Tedros Adhanom, the WHO Director-General said: “it’s about harnessing the power of nurses to achieve our vision for 2030, to achieve universal health coverage and to have a world which is healthier, safe, fairer for everyone”.
We all have a role to play in honoring this clarion call, starting with all civil servants, the private sector and other partners. I am calling on the Ministry of Finance during budget hearings they should put more premium on the nurses and midwives in Sierra Leone.
Ministry of Finance can contribute more to the health and well-being of nurses and midwives by partnering to ensure they are protected, motivated and supported to deliver health care.
The 2030 Agenda provides for strong political commitment to public health. It states that “To promote physical and mental health and well-being, and to extend life expectancy for all, we must achieve universal health coverage and access to quality health care.
No one must be left behind.” The 2030 Agenda sets out universal health coverage as an overarching theme and places greater emphasis on interaction with the social, economic and environmental dimensions of sustainable development. There are over 20 health targets across the Sustainable Development Goals. Health is positioned as a major contributor to other Sustainable Development Goals: without health many other Sustainable Development Goals cannot be achieved and, at the same time, health benefits from progress towards the other SDGs.
To what I am seeing Sierra Leone is committed to accelerating the move towards Universal Health Coverage and to ensure equitable access to quality health services for the entire population and this move is by providing of basic health services, free of charge, to service recipients under the Free Health Care Initiative and other services at an affordable cost through targeted subsidies.