The year 2020 is dedicated to nurses and midwives by the World Health Organisation (WHO), with the aim to create momentum and celebrate the incredible work of 22 million nurses and two million midwives who makes up half of the global health workforce and to highlight that the world needs nine million more nurses and midwives if it is to achieve universal health coverage by 2030.
Though nursing and midwifery are two different professions globally, in many countries such as Namibia, midwifery is either recognised as a branch of nursing or has some links to nursing such as a shared regulatory body. Midwifery is one of the oldest and most respected professions in the world. It has its roots in ancient wisdom and philosophies and maintains its contract with society in partnership with women and communities. Dating back in history, the word midwife comes from an old English word meaning “with woman,” and since women have been the traditional birth attendants throughout history, midwives have existed for as long as babies have been born.
Although the origins of nursing predate the mid-19th century, the history of professional nursing traditionally began with Florence Nightingale. Before the foundation of modern nursing, most cultures produced a stream of nurses dedicated to service on religious principles. Thus a nurse is a person who cares for the infirm. It is therefore arguably right to say the foundation of nursing and midwifery was based on a calling – this is however not the fact anymore as in modern life, nursing and midwifery practices are based on science.
The nursing and midwifery professions play a critical role in the contribution and achievement of universal health coverage. Did you know that nurses and midwives are at most one of the health care professionals who can play many roles at a given time but yet not fully recognised and not well remunerated? Could this be attributed to the fact that the professions were seen as a calling rather than professions? Indeed, during the 21st century, the generation of nurses and midwives have experienced changes to the professions and the professionals have built on the traditional way of rendering care by providing high-quality and evidence-based patient care. Thus, the exciting technological advancements and increased access to care has given nurses and midwives the opportunity to adapt and provide immediate, personalised/individualised care.
There exists a difference between nursing and midwifery. According to the International Council of Nurses (ICN), nursing encompasses an autonomous and collaborative care of individuals of all ages, families, groups and communities, sick and well in all settings. Nursing is about the promotion of health, prevention of illnesses, care of the ill, disabled and dying persons. Whereas the International Confederation of Midwives (ICM), defines midwifery as the profession which has a unique body of knowledge, skills and professional attitudes drawn from disciplines shared by other health professions such as science and sociology, but only midwives must practise midwifery within a professional framework of autonomy, partnership, ethics and accountability.
The misperception of nursing and midwifery to be a calling other than as professions have been suggested as one of the reasons leading to the attrition of nurses and midwives. However, it is important to know and recognise that the nursing and midwifery professions are autonomous, meaning that practitioners do not depend on another health professional cadres for them to perform their duties. Nurses and midwives have a professional accountability and they function within a scope of practice. Conversely, nurses and midwives are part of the multidisciplinary team of health care professionals and this indeed makes nursing and midwifery to be professions. The nursing and midwifery professions are sciences because their operations are dependent on scientific knowledge and evidence while respecting the values, cultures, norms and beliefs of clients. These two are distinct professions and not a calling.
The following are criteria which make nursing and midwifery to be referred to as professions: 1). The education of nurses and midwives is scientifically based and has to be learned and attained at a recognised institution of high learning. 2). Nurses and midwives are committed and motivated by altruism and the desire to always do good. 3).The behaviours of the professionals are directed and governed by a code of ethics. 4). Nursing and midwifery professions are well organised, they function autonomously and they are regulated by a professional body and in the Namibian context I am referring to the Health Professions Councils of Namibia particularly the Nursing Council. 5). Nurses and midwives are obliged to engage in continuous professional development activities to enable them to continue growing and developing their knowledge and skills at personal and professional levels. Therefore throughout the year, the work of nurses and midwives should be celebrated – indeed this is time for government and industries to prioritise investing in these two important professions. Nurses and midwives are the backbone of the health care systems and they should be supported in every aspect as they continue to showcast the incredible work that they do more especially during this time of Covid-19 pandemic. Being a nurse and a midwife myself, I recognise and acknowledge the important contribution of every nurse and midwife across the globe, however, I would like to urge my colleagues to take the professions seriously – we are in it and we understand it better. We are professionals and we should be well remunerated and recognised as such!
*Tekla Shiindi-Mbidi is a young midwife leader and a member of the board of directors – Independent Midwives Association of Namibia (IMANA).