Nursing poised to reduce health inequality
Despite major achievements in the realisation of the Millennium Development Goals (MDGs), there are still major gaps in the health status and life expectancy between high, middle and low income countries, between men and women and between rural and urban residents, according to the International Council of Nurses (ICN).
The ICN has underscored that while the ability to access health services is key to improving the health, well-being and life expectancy of all, achieving this fundamental requirement remains limited by cost, language, proximity, policies and practices, as well as many other factors. As the principal and, in some cases, the only group of health professionals providing primary health care in many of the most challenging settings, nurses are essential to improving equity and access to health care and adding quality to the outcome of care, the ICN has asserted. In observance of the International Nurses’ Day the ICN usually produces and distributes International Nurses Day (IND) Kits which contain educational and public information materials for use by nurses everywhere. This 2011 IND kit is geared at strengthening nurses understanding of access and equity and the effect of inequality on health. It also serves to outline the barriers that exist and how nurses can increase access and equity. It also shines a light on the importance of the social determinants of health, demonstrating how nurses can address these and in so doing improve access and ensure equity in the care provided. The ICN is of the firm belief too that nurses have an important role in achieving health equity and developing a clear understanding of how the health sector can act to reduce health inequities.
In 2001, the international community endorsed the MDGs, as it was recognised that the commitment to the MDGs represented a determination to make significant improvements in the health status of the world’s population. It was also observed then that the burden of illness and disease was not equally distributed. Major gaps existed in the health status and life expectations between the wealthy and the poor, between the developed and developing nations, between men and women and between rural and metropolitan residents.
Ten years on, significant gains have been made, with the 2009 evaluation report highlighting improvements in regards to key health interventions such as malaria and HIV control and measles immunisation (UN, 2010). However, the report also highlights yawning gaps between the health, well-being and life expectancy of different groups of people. The ability to access services has been recognised as key with a focus on the notion that access to services may be limited by cost, language, proximity, policies and practices that make a service culturally inappropriate, by poor quality, or simply by lack of availability or explicit rationing policies. It is also important to recognise, according to the ICN that health is not merely a commodity produced by health services but rather health is socially determined, as well as being influenced by genetics and environment. The ability to achieve good health or, conversely, the risk of suffering ill health, is affected by socio-economic status, geography, labour market participation, education, gender, sexual preference and a host of other elements that impact, both directly or indirectly on one’s ability to achieve and maintain good health.
The essential link between health and the living environment was recognised in 2005 when the World Health Organization (WHO) established the Commission on the Social Determinants of Health (CSDH) to “marshal the evidence of what can be done to promote health equity, and to foster a global movement to achieve it” (CSDH, 2008). As noted by that Commission (CSDH, 2008, p. 188), nurses and other health professionals have an important role to play in achieving health equity, and developing a strong understanding of how the health sector can act to reduce health inequities is vital. Nurses also need to understand their own role in the provision of equitable, accessible health care. As such the International Nurses Day Kit is aimed at assisting in nurses in this process.
Under the theme ‘Closing the Gap: Increasing access and equity’, International Nurses Day will be celebrated around the world on Thursday (May 12). However a week of activities has been streamlined by health professionals across the country.