Responding to the State of the World’s Nursing 2020 report in Aotearoa New Zealand: Aligning the nursing workforce to universal health coverage and health equity

Abstract
The World Health Organization’s State of the World’s Nursing (SoWN) 2020 report identified that the international maldistribution of the nursing workforce, particularly in high-income and developed countries, greatly impeded the United Nation’s Sustainable Development Goals and the World Health Organization priority of universal health coverage. Policy advice in the SoWN report emphasises investment in growing the nursing workforce to not only address a calculated shortfall of 5.9 million nurses internationally, but to augment domestic production of nurses in countries who are over-reliant on nurses trained overseas. Aotearoa New Zealand is one such country that is heavily reliant on internationally qualified nurses, with 27% of its total nursing workforce being migrants. Key prescriptions from the report include investment in nursing workforce data and its management; nursing leadership; nursing education; and the regulation of nurses. The report provides timely advice on the deep over-reliance on migrant nurses particularly in the context of the COVID-19 global pandemic, economic recession, and ballooning unemployment. Formulating a coherent national nursing workforce strategy is urgently needed to address the nursing workforce in Aotearoa New Zealand. This important work must align with improving population health outcomes and reducing the unacceptably high rates of health disparity. However, the SoWN report is all but silent on the international Indigenous nursing workforce and Indigenous health. To atone for this omission, Aotearoa New Zealand will need to address the persistent inequity of Māori in its nursing workforce by investing in the domestic growth of Māori nurses, as well as in Māori nursing leadership capacity and capability in order to better contribute to reducing Māori health inequity. Failure to invest in the domestic production of the nursing workforce at this juncture, and instead continuing to rely on the immigration of internationally qualified nurses would be unethical. Such critical responses to the SoWN report will be of value to Aotearoa New Zealand and international nursing audiences.

Ngā ariā matua
I puta te kī a te pūrongo State of the World’s Nursing (SoWN) 2020 ko te hē o te horapa o te kāhui kaimahi tapuhi puta noa i te ao, otirā i ngā whenua whiwhinga pūtea-nui, whenua kua eke ki ngā taumata whanaketanga, tētahi ārai nui mō te whāinga mātua o ngā Whāinga Whanaketanga Toitū o te Huihuinga o ngā Whenua o te Ao, me te Rōpū Hauora o te Ao. E kī ana ngā kupu tohutohu kaupapa here o te pūrongo SoWN he mea nui te haumitanga ki te whakatupu i te kāhui kaimahi tapuhi, kāpā kia whakatikaina te korenga tapuhi 5.9 miriona huri noa i te ao, engari hei whakapiki i te whakaputanga tapuhi i te wā kāinga i ngā whenua e whakawhirinaki atu ana ki ngā tapuhi kua whakangungua i tāwāhi. He whenua a Aotearoa e whakawhirinaki atu ana ki ngā tapuhi i whai tohu i tāwāhi, arā, 27 ōrau o te kāhui kaimahi tapuhi he tangata nō whenua kē. Ko ngā tohutohu matua o te pūrongo ko te haumi ki ngā raraunga kāhui kaimahi tapuhi me ōna whakahaere; ngā mahi hautū i te ao tapuhi; te mātauranga tapuhi; me ngā whakaritenga ā-ture mō ngā tapuhi. Tā tēnei pūrongo he hora whakamaherehere hāngai mō te kaha rawa o te whakawhirinaki ki ngā tapuhi o tāwāhi i ēnei rā o te mate urutā o KOWHEORI-19, te paheketanga ohaoha, me te kakenga nui o te koremahi. Me mātua whakaoti tētahi rautaki tapuhi ā-motu whai take hei whakatikatika i tō Aotearoa kaha whakawhirinaki atu ki ngā tapuhi nō whenua kē. Me whakahāngai tēnei mahi hira ki te whakapikinga o ngā putanga hauora taupori, me te whakaheke i ngā putanga tino rerekē mō tēnā wehenga mō tēnā wehenga o te taupori. Ahakoa ēnei mea katoa, kei te ngū tonu te pūrongo SoWN mō te kāhui tapuhi iwi taketake ā-ao, me te hauora iwi taketake. Hei whakatikatika i tēnei hapa nui, me tahuri Aotearoa ki te whakapiki i te korenga e ōrite o te iwi Māori i tōna kāhui kaimahi mā te haumi ki te whakapikinga i te kāinga nei o ngā tapuhi Māori, tae atu ki ngā āheinga me ngā pūmanawa o ngā kaihautū tapuhi Māori, hei mea e heke ai te korenga e ōrite o te hauora o te iwi Māori. Ki te kore e tika te haumi ki te whakaputanga i te kāinga o te kāhui kaimahi tapuhi i Aotearoa i tēnei wā, ka kīa he takahanga i te tika kia whakawhirinaki kau atu ki ngā kāhui taetae mai o ngā tapuhi whai tohu nō ngā whenua o tāwāhi. Ka noho ko ngā urupare arotake i te Pūrongo hei mea whai hua mō Aotearoa me ngā kaipānui tapuhi o te ao.

Keywords / Ngā kupu matua
COVID-19 / KOWHEORI-19; health equity / ōritenga hauora; health workforce / kāhui kaimahi hauora; Indigenous health / Hauora iwi taketake; internationally qualified nurses / ngā tapuhi whai tohu nō ngā whenua o tāwāhi; Māori health / hauora Māori; Māori nursing / ngā tapuhi Māori; health policy / kaupapa here hauora; nursing workforce / kāhui kaimahi tapuhi; universal health coverage / atawhainga hauora mō te katoa