Call to Action for Nurses/Nursing

8162019 Call to Action for NursesNursing

httpslidepdfcomreaderfullcall-to-action-for-nursesnursing 17

Review ArticleCall to Action for NursesNursing

Shahirose S Premji1234 and Jennifer Hatfield25

983089 Faculty of Nursing University of Calgary 983090983093983088983088 University Drive NW Calgary AB Canada 983090N 983089N983092983090Department of Community Health Sciences Cumming School of Medicine University of Calgary RW Building 983091rd Floor983091983090983096983088 Hospital Drive NW Calgary AB Canada 983090N 983092Z983094

983091OrsquoBrien Institute for Public Health Calgary AB Canada 983090N 983092Z983094 983092 Alberta Childrenrsquos Hospital Research Institute Calgary AB Canada 983090N 983092N983089983093

Institute for Gender Research Calgary AB Canada 983090N 983089N983092

Correspondence should be addressed to Shahirose S Premji premjisucalgaryca

Received 983090983096 October 983090983088983089983093 Revised 983096 February 983090983088983089983094 Accepted 983090983097 March 983090983088983089983094

Academic Editor Sten H Vermund

Copyright copy 983090983088983089983094 S S Premji and J Hat1047297eld Tis is an open access article distributed under the Creative Commons AttributionLicense which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited

Te 983089983091 million nurses worldwide constitute most o the global healthcare workorce and are uniquely positioned to engage withothers to address disparities in healthcare to achieve the goal o better health or all A new vision or nurses involves activeparticipation and collaboration with international colleagues across research practice and policy domains Nursing can embracenew concepts and a new approachmdashldquoOne World One Healthrdquomdashto animate nursing engagement in global health as it is uniquely positioned to participate in novelways to improve healthcare or thewell-being o theglobalcommunity Tisopinionpaper takes ahistorical andre1047298ective approach to inormand inspire nurses to engagein globalhealth practiceresearch andpolicy to achieve theSustainable Development Goals It can be argued that a colonial perspective currently inorms scholarship pertaining to nursingglobal health engagement Te notion o unidirectional relationships where those with resources support training o those lessortunate has dominated the raming o nursing involvement in low- and middle-income countries Tis paper suggests movingbeyond this conceptualization to a more collaborative and equitable approach that positions nurses as cocreators and brokers o knowledge We propose two concepts reverse innovation and two-way learning to guide global partnerships where nurses areactive participants

1 Background

Te eight Millennium Development Goals (MDGs) estab-

lished during the Millennium Summit o the United Nationsin 983090983088983088983088 markeda pledgeby 983089983096983097nations to osterinternationalrelations with shared values o reedom equality solidaritytolerance respect or nature and shared responsibility [983089]As global citizens determined to accelerate progress towardsMDGs nurse clinicians have been sharing knowledge andpartnering with colleagues in low- and middle-income coun-tries to identiy effective ways o working within the contexto their healthcare systems Te practice-based process andstrategies applied to improve individualsrsquo organizationsrsquo orcommunitiesrsquo ability to address health issues is reerred to ascapacity building [983090 983091] Historically this process was char-acterized by knowledge transer rom ldquonorth to southrdquo or

rom ldquodeveloped to developing countriesrdquo or ldquocolonizer tocolonizedrdquo and was ramed as ldquotransportingrdquo o knowledgeto buildcapacity [983092 983093] in different parts o the globe it is now

passe Recently global health orientations that seek to addressthese enduring approaches to north-south collaborationshave challenged the unidirectional 1047298ow o knowledge andskills [983094] and ollow more equitable partnership models [983090]We urge the nursing community to embrace a new ideology that is not based on or concerned with distinctionsmdashnorthand south low- and middle-income countries and high-income countries and developing and developed countriesmdashbut is rather concerned with One World One Health Tisopinion paper explains the concept One World One Healthand takes a historical and re1047298ective approach that invitesconsideration o concepts that can inorm the way nursingresponds to the challenges in global health engagement

Hindawi Publishing CorporationBioMed Research InternationalVolume 2016 Article ID 3127543 5 pageshttpdxdoiorg10115520163127543



983090 BioMed Research International

We examine terms such as capacity building and explicatehow they have been reramed and advanced in the globalhealth and nursing literature including the transormativenature o concepts such as reverse innovation and two-way learning We conclude by examining implications or nurs-ing and policy to instill a new perspectivemdashOne World OneHealth

2 One World One Health

Beyond the expiry o the MDGs it is argued that ldquothe healtho people in all countriesrdquo must be an overarching goal o a post-983090983088983089983093 ramework [983095] Emerging trends or instancemajority (983095983088) o the worldrsquos poor now reside in middle-income countries [983095] and associated challenges necessitateapplying post-983090983088983089983093 goals to all countries with modi1047297cation o targets and indicators depending on country context [983095] Tesentiment o our shared health concerns andcoming togethero experts and disciplines to address global challenges isimplied in the term ldquoOne World One Healthrdquo One World

One Health was coined in 983090983088983088983096 in reerence to a consultationdocument reviewed at the Sixth International MinisterialConerence on Avian and Pandemic In1047298uenza in Egypt [983094]One World One Health typi1047297es our interconnectednessbetween not only humans but nonhumans (ie animals)and our ecosystem and emphasizes coequal collaborationsand partnerships [983094] providing a privileged intersection inwhich the capacity o healthcare providers regardless o geographical boundaries is enhanced or societyrsquos well-being[983096]

One World One Health is a relatively new rame o reerence in nursing despite nursesrsquo unique position toaddress disparities in healthcare to attain health or all peoplearound the world Tere are 983089983091 million nurses worldwidewho are ront-line healthcare providers and by virtue o their roles and responsibilities have prolonged encounterswith patients and their amilies [983097] Nurse clinicians requirean inquiry approach situated within a cultural-competency ramework that promotes behaviors attitudes and practicesto come together in interpersonal and interproessionalrelationships that (a) acknowledge and view cultural differ-ences as strength (b) promote sel-re1047298ection to develop anunderstanding o their own culture attitudes and prejudices(c) avoid assumptions and stereotypes and (d) acilitateempathy despite language or communication barriers [983089983088983089983089] Moreover knowledge skills attitudes and core valueso nurses are 1047298uid [983093]mdashborderless We assert that or the

nursing proession to occupy a orceul role in promoting theaspirations o the Sustainable Development Goals we mustsee ourselves as partners with our international colleaguescocreating knowledge and sharing ideas and best practiceswith a view to seeking innovative solutions to shared healthchallenges

3 Transformative Nature of Knowledge Transfer Reverse Innovationand Two-Way Learning

Te term capacity building dominant in the developmentliterature since the 983089983097983095983088s has a historical trajectory inormed

by colonial perspectives and unequal power relationshipsCapacity building has been reramed to include notions suchas working collaboratively to enhance peoplersquos leadership andcommitment (ie dynamic capabilities) to effect change inthe conditions o their communities through action (egdiscovering new ways o doing things) or responsiveness to

the changing environment [983091 983089983090ndash983089983092] Moving beyond thecolonial perspective to a more ethical equitable approachleads to raming this process in terms o the quality o the relationships that are nurtured between nurses Tisspirit and approach are best characterized by the concept o knowledge transer [983092] Knowledge transer promotes accessto new knowledge generally created through research tothose who will use this knowledge Te use o this knowledgeis intended to improve outcomes o health and ensureeffective use o resources andtime [983092 983089983093] Knowledge transerentails a social process in which a knowledge manager orbroker seeks out existing evidence or seeks to bring researchactivities more in line with users o knowledge [983092 983089983093] Nursesneed to participate in new ways within this social processdeveloping competencies to promote social economic andpolitical action that not only exposes the health inequali-ties (eg social determinants o health) [983089983094] but identi1047297esinnovative approaches to reorm healthcare delivery Teknowledge transerexperience should be transormative to allindividuals engaged in the experience creator o knowledgebroker o knowledge and user o knowledge

With growing awareness o the transormative nature o international activities concepts such as reverse innovationand two-way or shared learning have also been advancedin the literature Reverse innovation is a term that appearedin 983090983088983088983097 and is more prominent in the business literature Itentails applying successul innovative approaches originatingrom low- and middle-income countries (driven by limitedresources) to high-income countries in order to transormhealthcare systems and improve health outcomes o patientsand communities [983089983095ndash983089983097] For example North Wales imple-mented a Brazilian amily health strategymdashuniversal primary care servicesmdashin which primary care teams comprising adoctor nurse nurse auxiliary and our community healthworkers delivered primary care services to households withintheir de1047297ned geographic area whether or not the householdexpress a need or service [983090983088] A number o barriershowever in1047298uence reverse innovation including weak 1047298ow inrastructure narrow-mindedness and early ailures [983089983095]Overcoming these barriers is important to realize that the

goal o reverse innovation is ldquoto contribute to the countlesshealth challenges aced by populations across the worldrdquo [983089983095p 983090] Te 983089983091 million nurses worldwide can promote a ldquoglobalinnovation 1047298owrdquo that is bidirectional sharing knowledgeskills ideas and lessons learned around the world in orderto cocreate clinical practice solutions or the world [983089983095 983090983089]Moreover this global innovation 1047298ow should be linked to theSustainable Development Goals (eg ldquoensure healthy livesand promote well-being or all at all agesrdquo) in a way that seeksto achieve economic social and environmental developmentwith hopes o eliminating all orms o poverty [983089983095 983090983090] Assuch nurses need to embrace new ways o doing a paradigmshif which entails examining problems across situations or



BioMed Research International 983091

983137983138983148983141 983089 Key recommendations or nursing engagement in global health

Stakeholder group Recommendation

Nurses Need to participate in the conversation at every level (eg academic association and policy)

and develop emotional intelligence

Proessional nursing education programs Help nurses develop competencies and attributes or engagement in global health reorm

Interproessional education programs Promote networking collaboration nonhierarchical relationships and common goalsNurse clinicians Need inquiry approach situated within a cultural-competency ramework

Nursing community Embrace One World One Health

contexts being inclusive o other disciplines to explore thecomplex nature o the problem and 1047297nding alternate andcreative solutions At the oreront o these solutions shouldbe the principles o dignity prosperity justice partnershipplanet and people [983095]

Similarly two-way learning is synonymous with reversecapacity development which reers to the altered percep-tion particularly awareness and understanding o these

perspectives or worldviews that can be ldquotranslatedrdquo intoaction that can potentially inorm practice ldquoat homerdquo [983089983092]Only one article in the policing literature precisely reerredto the concept o reverse capacity development [983089983092] Teauthors re1047298ected on Australian police officersrsquo experiencesrelated to peace keeping and capacity building in SolomonIslands imor-Lester and Papua New Guinea Harris andGoldsmith [983089983092] reer to a ldquopositive effectrdquo o these reversecapacity building experiences such as enhanced repertoire o skills to improve structures or processes in their workplacethat go beyond enhancing onersquos own clinical and cultural-competency skills

Cross-cultural competencies are one strategy to improve

patient outcomes and eliminate racial and ethnic disparitiesin health outcomes [983089983088] Health inequities however arealso rooted in social determinants o health (eg socialstatus income gender disability or sexual orientation) [983090983091]Nursing involvement in the global innovation 1047298ow offers anopportunity to support learning in utilizing the social deter-minants o health ramework ldquoat homerdquo to increase access tonot only quality care but health resources thereby reducinghealth inequities [983090983091 983090983092] Indirectly it increases nursingworkorce diversity which has been identi1047297ed as an impor-tant strategy to overcome health inequities [983090983091 983090983092] Nursingengagement in the ldquoglobal innovation 1047298owrdquo is an innovativestrategy to reduce inequality within countriesmdashnursingrsquos

contribution to moving towards Sustainable DevelopmentGoal (eg Goal 983089983088 ldquoreducing inequality within and amongcountriesrdquo) [983089] o ensure an effective healthcare system thatis accessible sae effective and affordable around the worldnurses also need to change the conversion to in1047298uence policy (health and social) [983090983093]

4 Nursing Engagement inChanging Conversation

Nurses have the potential and ofen the interest to partic-ipate in addressing many o the global health issues (egnoncommunicable disease) [983097] through engagement in areas

o healthcare reorm that are common across all countriesdespite contextual differences [983090983094 983090983095] Tey are uniquely positioned to acilitate shared learning globally and engagein reverse innovation and reverse capacity development (ietwo-way learning) Reports and studies [983097 983090983094ndash983090983096] suggestthat nurses are viewed as trusted proessionals who have theability to in1047298uence elements o healthcare reorm Toughthere is an appreciation that nurses will need to increase their

visibility in shaping international practice and policy deci-sions (eg international agencies national capitals) [983097 983090983094ndash983090983096] Te International Council o Nurses realizes that nurseswill need to betterunderstand the global health discourseandshape and reshape the conversations at multiple levels (ieintrapersonal interpersonal organizational and sociocul-tural) to inorm world views and promote behavior changethat is involvement in healthcare reorm that will lead tohealth or all [983090983095] Te Global Advisory Panel or the Futureo Nursing convened by Sigma Teta au International hascreated a platorm or these conversations to increase nursesrsquocontribution to global health [983090983097]

Reverse innovation and two-way learning create an open-

ness to ldquochange the conversationrdquo [983091983088] that is engage in dis-course to promote change in thinking and behavior (ie tak-ing action in global healthcare reorm) Reverse innovationand two-way learning can promote respect or intellectualpartnerships and shared exchange o knowledge ideas skillsand innovation across borders [983089983097] It does not however dis-pel the power dynamics or the view o them and the ldquootherrdquoMoreover reverse innovation and capacity developmentalthough helpulconceptsare notsufficientand must be com-plemented by an understanding that embodies the complexinterrelationship between community engagement and core

values o social responsibility justice and equity

5 Implications for Nursing and Health Policy

Access to high-quality and high-value care should be aundamental right o every patient regardless o the country in which they are receiving healthcare services Te post-983090983088983089983093 United Nations Sustainable Development Goals aspireto this agenda in ways that differ rom the ldquodonor-recipientrdquoparadigm o the MDG as it empowers every individual toaction [983095 983091983089] Participation o nurses a key principle o theSustainable Development Goals at every level (see able 983089)will be imperative to reorm healthcare to move towardsthis agenda (ie improving access and quality while makinghealthcare affordable) [983091983090]




Nursing academic and proessional institutions are inte-gral to creating an enabling environment or nurses todevelop the skills and competencies to participate in address-ing inequities in health and healthcare delivery Proessionalnursing education programs must help nurses develop com-petencies (eg political leadership team work) and attributes

(eg in1047298uence proessional credibility) that are undamentalor nursing engagement in global health and health reorm[983091983090ndash983091983092] o improve health system perormance leadershipcritical reasoning anddata management skills are required togenerate and use data to inorm decisions regarding clinicalresearch and education practice and policy [983090983093 983091983091] Nursesare apt at adopting and implementing policy but appear tobe peripheral in inorming and shaping policy [983091983093] Interpro-essional education to promote networking collaborationnonhierarchical relationships and common goals will resolveissues related to proessional silos and exclusion o nursesat the policy table [983091983090 983091983091] Emotional intelligence (ie sel-awareness andsocial astuteness) will enable nurses to managesocial and cultural actors that impede their involvement inpromoting changes in practice education and policy [983091983090]Proessional institutions maintain the responsibility o (a)ensuring nursing presence during policy decision-making(b) preserving a united ront and (c) guiding nurses toremain proactive in lobbying government and stakeholderto address social determinants o health which in1047298uencehealth and access to healthcare [983091983090] Nurses will need tohold governments nongovernmental organizations privatesectors and academic and proessional institutions amongothers accountable to the commitments made in deliveringpriorities in the Post-983090983088983089983093 Development Agenda [983091983094]

6 Conclusion

Tis paper intends to begin conversation among nurses abouttheir engagement in global health and identiy actions to par-ticipate in health reorm required to promote health or allGrounding nursing conversation in the concepts articulatedabove will guide change [983091983088] in that it will enable nurses tobe accountable to both patient care and healthcare leadership[983090983095] In so doing nurses can in1047298uence organizational andpolitical context o care cocreate global solution or carethrough ldquoglobal innovation 1047298owrdquo and emphasize primary care to promote well-being o populations [983090983095] Disengage-ment on the other hand will result in preserving the status

quo and increase healthcare spending without improvementin patient and population well-being

Competing Interests

Te authors declare that there are no competing interestsregarding the publication o this paper

References

[983089] United Nations Development Programme Te MillenniumDevelopment Goals Eight Goals for 983090983088983089983093 983090983088983089983092 httpwwwundporgcontentundpenhomemdgoverviewhtml

[983090] B R Crisp H Swerissen and S J Duckett ldquoFour approachesto capacity building in health consequences or measurementand accountabilityrdquo Health Promotion International vol 983089983093 no983090 pp 983097983097ndash983089983088983095 983090983088983088983088

[983091] R Kislov H WatermanG Harvey and R Boaden ldquoRethinkingcapacity building or knowledge mobilisation developing mul-tilevel capabilities in healthcare organisationsrdquo ImplementationScience vol 983097 article 983089983094983094 983090983088983089983092

[983092] M Meyer ldquoTe rise o the knowledge brokerrdquo Science Commu-nication vol 983091983090 no 983089 pp 983089983089983096ndash983089983090983095 983090983088983089983088

[983093] A Keeling ldquoGlobal perspectives on nursingrdquo Window in ime vol 983090983089 no 983089 pp 983089ndash983090 983090983088983089983091

[983094] World Bank People Pathogens and Our Planet Volume 983089oward a One Health Approach for Controlling Zoonotic DiseaseWorld Bank Washington DC USA 983090983088983089983088 httpsiteresourcesworldbankorgINARDResourcesPPP Webpd

[983095] I Kickbusch and C Brindley Health in the Post-983090983088983089983093Development Agenda An Analysis of the UN-Led TematicConsultations High-Level Panel Report and SustainableDevelopment Debate in the Context of Health World Health

Organization Geneva Switzerland 983090983088983089983091 httpgraduateinsti-tutech1047297leslivesitesiheid1047297lessitesglobalhealthshared983089983096983097983092PublicationsHealth-in-the-Post-983090983088983089983093 v983095pd

[983096] L O Gostin and M Powers ldquoWhat does social justice requireor the publicrsquos health Public health ethics and policy impera-tivesrdquo Health Affairs vol 983090983093 no 983092 pp 983089983088983093983091ndash983089983088983094983088 983090983088983088983094

[983097] International Council o Nurses ldquoNurses convene in Malta toshare knowledge discuss global health prioritiesrdquo International Nursing Review vol 983093983096 no 983091 pp 983090983095983095ndash983090983095983097 983090983088983089983089

[983089983088] D A Lie E Lee-Rey A Gomez S Bereknyei and C HBraddock III ldquoDoes cultural competency training o healthproessionals improve patient outcomes A systematic review and proposed algorithm or uture researchrdquo Journal of General

Internal Medicine vol 983090983094 no 983091 pp 983091983089983095ndash983091983090983093 983090983088983089983089[983089983089] K Bhui N Wara P Edonya K McKenzie and D Bhugra

ldquoCultural competence in mental health care a review o modelevaluationsrdquo BMC Health Services Research vol 983095 article 983089983093983090983088983088983095

[983089983090] S Barakat and M Chard ldquoTeories rhetoric and practicerecovering the capacities o war-torn societiesrdquo Tird World Quarterly vol 983090983091 no 983093 pp 983096983089983095ndash983096983091983093 983090983088983088983090

[983089983091] D C Korten ldquoCommunity organization and rural devel-opment a learning process approachrdquo Public AdministrationReview vol 983092983088 no 983093 pp 983092983096983088ndash983093983089983089 983089983097983096983088

[983089983092] V Harris and A Goldsmith ldquoInternational police missionsas reverse capacity building experiences o Australian policepersonnelrdquo Policing vol 983091 no 983089 pp 983093983088ndash983093983096 983090983088983088983097

[983089983093] V L Ward A O House and S Hamer ldquoKnowledge brokeringexploring the process o transerring knowledge into actionrdquoBMC Health Services Research vol 983097 no 983089 p 983089983090 983090983088983088983097

[983089983094] M Marmot S Friel R Bell A Houweling and S aylorldquoClosing the gap in a generation health equity through actionon the social determinants o healthrdquo Te Lancet vol 983091983095983090 no983097983094983093983088 pp 983089983094983094983089ndash983089983094983094983097 983090983088983088983096

[983089983095] S B Syed V Dadwal and G Martin ldquoReverse innovationin global health systems towards global innovation 1047298owrdquoGlobalization and Health vol 983097 article 983091983094 983090983088983089983091

[983089983096] J R Immelt V Govindarajan and C rimble ldquoHow GE isdisrupting itselrdquo Harvard Business Review vol 983096983095 no 983089983088 pp983093983094ndash983094983093 983090983088983088983097




[983089983097] A Binagwaho C Nutt V Mutabazi et al ldquoShared learning inan interconnected world innovations to advance global healthequityrdquo Globalization and Health vol 983097 article 983091983095 983090983088983089983091

[983090983088] C D Johnson J Noyes A Haines et al ldquoLearning rom theBrazilian community health worker model in North WalesrdquoGlobalization and Health vol 983097 no 983089 p 983090983093 983090983088983089983091

[983090983089] N Crisp ldquoMutual learning and reverse innovation-wherenextrdquo Globalization and Health vol 983089983088 article 983089983092 983090983088983089983092

[983090983090] United Nations ransforming our World Te 983090983088983091983088 Agenda for Sustainable Development Sustainable Development Knowl-edge Platorm New York NY USA 983090983088983089983093 httpssustainable-developmentunorgpost983090983088983089983093transormingourworld

[983090983091] J M Phillips and B Malone ldquoIncreasing racialethnic diversity in nursing to reduce health disparities and achieve healthequityrdquo Public Health Reports vol 983089983090983097 supplement 983090 pp 983092983093ndash983093983088983090983088983089983092

[983090983092] S D Williams K Hansen M Smithey et al ldquoUsing socialdeterminants o health to link health workorce diversity carequality and access and health disparities to achieve healthequity in nursingrdquo Public Health Reports vol 983089983090983097 supplement983090 pp 983091983090ndash983091983094 983090983088983089983092

[983090983093] S L Ferguson ldquoAn activist looks at nursingrsquos role in healthpolicy developmentrdquo Journal of Obstetric Gynecologic and Neonatal Nursing vol 983091983088 no 983093 pp 983093983092983094ndash983093983093983089 983090983088983088983089

[983090983094] C M Khoury R Blizzard W W Moore and S HassmillerldquoNursing leadership rom bedside to boardroom a gallupnational survey o opinion leadersrdquo Journal of Nursing Admin-istration vol 983092983089 no 983095-983096 pp 983090983097983097ndash983091983088983093 983090983088983089983089

[983090983095] P Blaney ldquoSenior nursing leadershipmdashcapacity building at theglobal levelrdquo International Nursing Review vol983093983097 no 983089pp 983092983088ndash983092983095 983090983088983089983090

[983090983096] World Health Organization Te World Health Report 983090983088983088983096mdashPrimary Health Care (Now More Tan Ever) World HealthOrganization Geneva Switzerland 983090983088983088983096 httpwwwwhointwhr983090983088983088983096en

[983090983097] H C Klopper andM Hill ldquoGlobal advisory panel on the utureo nursing (GAPFON) and global healthrdquo Journal of Nursing Scholarship vol 983092983095 no 983089 pp 983091ndash983092 983090983088983089983093

[983091983088] R Marshak and D Grant ldquoCreating change by changingconversationrdquo OD Practitioner vol 983092983091 no 983091 pp 983090ndash983095 983090983088983089983089

[983091983089] B Carin and M Kapila oward a Post-983090983088983089983093 Paradigm (II)Centre or International Governance Innovation WaterlooCanada 983090983088983089983089 httpwwwcigionlineorg

[983091983090] Fyffe ldquoNursing shaping andin1047298uencing health and socialcarepolicyrdquo Journal of Nursing Management vol 983089983095 no 983094 pp 983094983097983096ndash983095983088983094 983090983088983088983097

[983091983091] J Frenk ldquoBridging the divide global lessons rom evidence-based health policy in Mexicordquo Te Lancet vol 983091983094983096 no 983097983093983091983097

pp 983097983093983092ndash983097983094983089 983090983088983088983094[983091983092] N Shariff ldquoA Delphi survey o leadership attributes necessary

or national nurse leadersrsquo participation in health policy devel-opment an East Arican perspectiverdquo BMC Nursing vol 983089983092article 983089983091 983090983088983089983093

[983091983093] N Shariff and E Potgieter ldquoExtent o East-Arican nurseleadersrsquo participation in health policy developmentrdquo Nursing Research and Practice vol 983090983088983089983090 Article ID 983093983088983092983094983097983095 983095 pages983090983088983089983090

[983091983094] United Nations Development Groups Developing the Post-983090983088983089983093Development Agenda Opportunities at the National and Local Levels United Nations Development Groups New York NYUSA 983090983088983089983092 httpsdocsgooglecomgviewurl=httpsustainable-developmentunorgcontentdocuments983089983097983088983097UNDP-MDG-Delivering-Post-983090983088983089983093-Report-983090983088983089983092pdampembedded=true



Submit your manuscripts at

httpwwwhindawicom



C o p y r i g h t o f B i o M e d R e s e a r c h I n t e r n a t i o n a l i s t h e p r o p e r t y o f H i n d a w i P u b l i s h i n g

C o r p o r a t i o n a n d i t s c o n t e n t m a y n o t b e c o p i e d o r e m a i l e d t o m u l t i p l e s i t e s o r p o s t e d t o a

l i s t s e r v w i t h o u t t h e c o p y r i g h t h o l d e r s e x p r e s s w r i t t e n p e r m i s s i o n H o w e v e r u s e r s m a y p r i n t

d o w n l o a d o r e m a i l a r t i c l e s f o r i n d i v i d u a l u s e




We examine terms such as capacity building and explicatehow they have been reramed and advanced in the globalhealth and nursing literature including the transormativenature o concepts such as reverse innovation and two-way learning We conclude by examining implications or nurs-ing and policy to instill a new perspectivemdashOne World OneHealth

2 One World One Health

Beyond the expiry o the MDGs it is argued that ldquothe healtho people in all countriesrdquo must be an overarching goal o a post-983090983088983089983093 ramework [983095] Emerging trends or instancemajority (983095983088) o the worldrsquos poor now reside in middle-income countries [983095] and associated challenges necessitateapplying post-983090983088983089983093 goals to all countries with modi1047297cation o targets and indicators depending on country context [983095] Tesentiment o our shared health concerns andcoming togethero experts and disciplines to address global challenges isimplied in the term ldquoOne World One Healthrdquo One World

One Health was coined in 983090983088983088983096 in reerence to a consultationdocument reviewed at the Sixth International MinisterialConerence on Avian and Pandemic In1047298uenza in Egypt [983094]One World One Health typi1047297es our interconnectednessbetween not only humans but nonhumans (ie animals)and our ecosystem and emphasizes coequal collaborationsand partnerships [983094] providing a privileged intersection inwhich the capacity o healthcare providers regardless o geographical boundaries is enhanced or societyrsquos well-being[983096]

One World One Health is a relatively new rame o reerence in nursing despite nursesrsquo unique position toaddress disparities in healthcare to attain health or all peoplearound the world Tere are 983089983091 million nurses worldwidewho are ront-line healthcare providers and by virtue o their roles and responsibilities have prolonged encounterswith patients and their amilies [983097] Nurse clinicians requirean inquiry approach situated within a cultural-competency ramework that promotes behaviors attitudes and practicesto come together in interpersonal and interproessionalrelationships that (a) acknowledge and view cultural differ-ences as strength (b) promote sel-re1047298ection to develop anunderstanding o their own culture attitudes and prejudices(c) avoid assumptions and stereotypes and (d) acilitateempathy despite language or communication barriers [983089983088983089983089] Moreover knowledge skills attitudes and core valueso nurses are 1047298uid [983093]mdashborderless We assert that or the

nursing proession to occupy a orceul role in promoting theaspirations o the Sustainable Development Goals we mustsee ourselves as partners with our international colleaguescocreating knowledge and sharing ideas and best practiceswith a view to seeking innovative solutions to shared healthchallenges

3 Transformative Nature of Knowledge Transfer Reverse Innovationand Two-Way Learning

Te term capacity building dominant in the developmentliterature since the 983089983097983095983088s has a historical trajectory inormed

by colonial perspectives and unequal power relationshipsCapacity building has been reramed to include notions suchas working collaboratively to enhance peoplersquos leadership andcommitment (ie dynamic capabilities) to effect change inthe conditions o their communities through action (egdiscovering new ways o doing things) or responsiveness to

the changing environment [983091 983089983090ndash983089983092] Moving beyond thecolonial perspective to a more ethical equitable approachleads to raming this process in terms o the quality o the relationships that are nurtured between nurses Tisspirit and approach are best characterized by the concept o knowledge transer [983092] Knowledge transer promotes accessto new knowledge generally created through research tothose who will use this knowledge Te use o this knowledgeis intended to improve outcomes o health and ensureeffective use o resources andtime [983092 983089983093] Knowledge transerentails a social process in which a knowledge manager orbroker seeks out existing evidence or seeks to bring researchactivities more in line with users o knowledge [983092 983089983093] Nursesneed to participate in new ways within this social processdeveloping competencies to promote social economic andpolitical action that not only exposes the health inequali-ties (eg social determinants o health) [983089983094] but identi1047297esinnovative approaches to reorm healthcare delivery Teknowledge transerexperience should be transormative to allindividuals engaged in the experience creator o knowledgebroker o knowledge and user o knowledge

With growing awareness o the transormative nature o international activities concepts such as reverse innovationand two-way or shared learning have also been advancedin the literature Reverse innovation is a term that appearedin 983090983088983088983097 and is more prominent in the business literature Itentails applying successul innovative approaches originatingrom low- and middle-income countries (driven by limitedresources) to high-income countries in order to transormhealthcare systems and improve health outcomes o patientsand communities [983089983095ndash983089983097] For example North Wales imple-mented a Brazilian amily health strategymdashuniversal primary care servicesmdashin which primary care teams comprising adoctor nurse nurse auxiliary and our community healthworkers delivered primary care services to households withintheir de1047297ned geographic area whether or not the householdexpress a need or service [983090983088] A number o barriershowever in1047298uence reverse innovation including weak 1047298ow inrastructure narrow-mindedness and early ailures [983089983095]Overcoming these barriers is important to realize that the

goal o reverse innovation is ldquoto contribute to the countlesshealth challenges aced by populations across the worldrdquo [983089983095p 983090] Te 983089983091 million nurses worldwide can promote a ldquoglobalinnovation 1047298owrdquo that is bidirectional sharing knowledgeskills ideas and lessons learned around the world in orderto cocreate clinical practice solutions or the world [983089983095 983090983089]Moreover this global innovation 1047298ow should be linked to theSustainable Development Goals (eg ldquoensure healthy livesand promote well-being or all at all agesrdquo) in a way that seeksto achieve economic social and environmental developmentwith hopes o eliminating all orms o poverty [983089983095 983090983090] Assuch nurses need to embrace new ways o doing a paradigmshif which entails examining problems across situations or































6 Conclusion



Competing Interests


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6 Conclusion



Competing Interests


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6 Conclusion



Competing Interests


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httpwwwhindawicom










httpwwwhindawicom













Documents

Call to Action for Nurses/Nursing