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Creating a global covenant for healthcare reform in nursing

02 November 2019
Volume 30 · Issue 11

Abstract

Social determinants of health continue to exist and perpetuate health inequalities. Catherine Best explores the contribution of nurses on an international scale, particularly in regards to solving inequality in access to healthcare

Encouraging nursing to be a global profession has gained considerable momentum in recent years. For significantly longer, social determinants of health have featured in multiple national and international reports, and their devastating impacts on societies, both nationally and globally, are still being experienced. The time for rhetoric has long gone. Instead, unprecedented action is needed to bring this to the fore of all governments across the globe. The World Health Organization, International Council of Nurses and the United Nations have done much to raise awareness of the need for change and make it clear that the nursing profession can contribute to take positive action. The provision of good healthcare should not be reliant on where you live and work, but should be available to everyone. This article will explore the difference that nurses can make to the everyday lives of those we care for, and in improving equal access to healthcare for everyone.

History has shown that the nursing profession has done much to enhance population wellbeing through the understanding of social determinants of health (SDoH) (Stewart-Fahs, 2017). SDoH are defined by the World Health Organization (WHO) (2019a) as:

‘The conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.’

As nurses witness the poor health associated with SDoH, they are uniquely placed to recognise the growing causative factors. In doing so, nurses play a significant role in reducing the impact of social injustice by becoming actively involved in ensuring that appropriate services are commissioned (Royal College of Nursing (RCN), 2012). This can be achieved, for example, through the process of shared decision making, an approach that allows patients and health professionals to work collaboratively to decide the most appropriate care provision based on the best available researched evidence and the patients informed preferences—a process ultimately linked to improved health outcomes (Coulter and Collins, 2011).

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