“Midwives and nurses contribute to the health of women, families, communities, and society at large, but the impact of their care goes much further… Their care is transformational,” said Diene Keita, Deputy Executive Director for Programmes at UNFPA. She spoke at a recent event hosted by Women in Global Health, which virtually convened nurses and midwives from around the world to celebrate 100 outstanding women nurse and midwife leaders from over 50 countries. The event occurred in honor of the Year of the Nurse and the Midwife, as designated by the World Health Organization (WHO). The list of 100 leaders is the first global recognition of its kind and commemorates women’s unique stories of resilience, leadership, and hard work.

While there are 100 women recognized on the list, there are millions more who are on the frontlines everyday protecting and serving their communities that go unnoticed, said Roopa Dhatt, Executive Director of Women in Global Health. The included leaders “symbolize the hard work that millions of nurses and midwives are doing to provide care,” she said.

Recognizing Women’s Contributions

The value of midwifery and nursing, where women are the majority, cannot be overstated. According to the recent study, Impact of Midwives, universal coverage of midwife-delivered interventions by 2035 can save over 4 million lives per year. Nurses are also providing essential care, yet experts fear the nursing workforce is bottoming out. The 2020 State of the World’s Nursing Report shows that we are six million nurses short from universal coverage, said Annette Kennedy, President of the International Council of Nurses. In addition, approximately 2,700 nurses have died from COVID-19 and many more are experiencing trauma and burnout due to long hours, loss of patients, and the stress and risk of working without proper personal protective equipment. In the next ten years, an estimated four million nurses will retire. “We are worried, because even if a small proportion of those leave, we could be looking at a 50 percent reduction in our nursing workforce,” said Kennedy, who called for action to support and retain the nursing workforce.

“No health service can exist without women,” said Kennedy. Women make up 70 percent of the health workers on the frontlines during the pandemic, yet only 25 percent of senior leadership and decision-making positions. Many of the recognized leaders spoke about the need for more women holding leadership positions in global health. “We must work together to ensure midwives and nurses are empowered and in decision-making at all levels, especially so they can protect the interests of the women and the girls,” said Keita.

The Danger of a Single Story

“We have to make sure that as history is getting written, we recognize women’s contributions,” said Dhatt. It is important to hear their stories and remember the important impact they had during the pandemic, she said, as history is not usually written by women.

Elizabeth Iro, Chief Health Officer at WHO, stressed the importance of listening to the stories of nurses and midwives on the frontline to inspire change and action and discussed “the danger of a single story,” a concept she attributed to Nigerian writer Chimamanda Ngozi Adichie. “We are impressionable and vulnerable in the face of a story,” said Iro. Listening to a variety of women’s experiences is necessary to understand how to better support women healthcare workers in different regions, and to “remind us of what more we can do,” she said.

Speakers from every region of the world shared their reasons for becoming healthcare workers and their experiences during the pandemic. Debrah Lewis, a midwife from Trinidad and Tobago and board member of ICM, said she became a midwife because she grew up accompanying her mother to the Red Cross where she volunteered. Yet, Lewis described her work as lacking respect, recognition, and support. She works to get more midwives at decision-making tables. Nailantei Kileku, a nurse and midwife from Kenya, works to ensure women have access to reproductive healthcare during the pandemic and to prevent avoidable maternal deaths. She contacted stakeholders in her community to find creative ways for women to access resources from home, due to curfews and other restrictive measures meant to reduce the spread of COVID-19. Etti Rosenberg, a nurse from Israel, utilized the power of social media to connect nurses during the pandemic. She created a Facebook page for nurses to share their stories and find support, and now she is turning the stories into a book.

Turning Applause into Action

There is ample evidence that nurses and midwives are essential to health systems and have the potential to save millions of lives. While it is important to listen to these stories and pause to congratulate women leaders in healthcare, we must make sure this applause turns into action. “The question remains, if it is really so obvious, then why are we not adequately investing in our nursing and midwifery workforce?” asked Geeta Lal, Senior Technical Advisor at UNFPA.

As the Year of the Nurse and the Midwife came to a close, WHO designated 2021 the Year of the Health and Care Workers. This campaign calls for urgent action to invest in the health and care workforce under the themes “protect, invest, together.” We must protect the health and care workforce by prioritizing them in the vaccine rollout, invest in jobs and education to provide decent working conditions, and work together to support these workers both in the pandemic and under all other circumstances. Leaders in the healthcare community must use the evidence shared to advance policy in their own countries and “create an enabling environment for the health workforce,” said Lal.