European Action Plan for Strengthening Public Health Capacities and Services: Cyprus Nurses and Midwives Association (CYNMA)

Comments and Position Statements For Development.

The  proposal of Cyprus Nurses and Midwives Association (CYNMA)  for strengthening public health, is written in an effort to follow the eight avenues for action that have been developed by world Health Organization (WHO) and its regional office for Europe,   for the purpose of the given draft, CYNMA agrees with the whole draft given for comments as we believe that it can allow the implementation of the ten essential public health operations (EPHOs that have previously been developed) in an effort to protect public from exposures that cause harm and improve the health of the community.

However, CYNMA proposes some additional points to the draft of the European Action Plan for Strengthening Public Health Capacities and Services that are mostly related with the role of Nurses, Midwives and Health Visitors regarding Public Health. These are as follows:

  • Nursing and Midwifery Associations in each Country must make clear to their members that it is a right, as well as, a responsibility, of nurses midwives and health visitors to promote public health in all healthcare settings and improve and protect the health of the public.
  • CYNMA believes that most countries face major challenges regarding Public Health issues and Nursing and Midwifery Associations have an important role in dealing with these challenges: Among others, health inequalities are widespread, the risks like pandemics appear, new health threats emerge and there is an increasing burden of chronic non communicable diseases (NCDs). Through conferences, meetings, other activities and events among their members and in collaboration with societal organizations and patient support groups, Nursing and Midwifery Associations must work to improve and protect the nation’s health and prevent illnesses. Thus, they must upgrade their role as health defenders and promoters.
  • The issue of health inequalities is widespread in the draft of the European Action Plan for Strengthening Public Health Capacities and Services and CYNMA agrees that it is a major Public Health issue. Therefore, an urgent attention and action is needed, from the World Health Organization (WHO), the civil society, the national governments of each country, and the health associations or organizations, including the National Nursing and Midwifery Associations all over the world, towards dealing with this challenge. Agreeing with the WHO’s Commission (2008) final report, on Social Determinants of Health with the title Closing the gap in a generation” CYNMA believes that the given draft could have in its beginning, a sub – chapter where the issue of health inequality, its causes and its strategic management, could be further explored in the context of Public Health.
  • The  increasing  burden  of  chronic  non  communicable  diseases  (NCDs),  such  as cardiovascular diseases, cancer, diabetes mellitus, mental health problems, chronic diseases, injuries, disabilities, musculoskeletal conditions and others, absorb substantial amounts  of  resources  of  the  health  systems  all  over  the  world,  including  Cyprus. CYNMA believes that each country in collaboration with WHO, must further develop and implement certain policies and strategies, for the prevention, the early detection, the management and the control of NCDs. National Nursing and Midwifery Associations should have an important role and input, in all the stages of these efforts.
  • CYNMA believes that  all Public Health efforts should be approached through a “general course of life” – from born well, developing and growing up well, living and working well, and ageing well.  An emphasis should be given also in good mental health as it is central to wellbeing and physical health.
  • CYNMA believes that Nurses, Midwives and Health Visitors are given trust by the public regarding the provision of health information and advice as they have very good knowledge ranging from biomedical to psychosocial care while they work holistically and with skills in an effort to build relationships with individuals, families and communities. In this manner, nurses can help to greatly improve health and wellbeing throughout the lifespan of citizens in each country.
  • CYNMA believes that Nurses, Midwives and Health Visitors, play an important role in making every health encounter to  count towards a healthier lifestyle,  wellbeing and prevention of illness. Perhaps they are in better work position than every other health professional since they are closer to patients, families and communities, many of which are at certain life events when people are more receptive to advice regarding health. Nurses Midwives and Health Visitors must ensure that they recognize these significant moments and provide health advice in sensitive and effective ways.
  • CYNMA  believes  that  the  encouragement  and  promotion  of  nursing  and  midwifery research among staff and the use of statistical data in clinical practice and the evidence- based approaches to nursing services, could significantly add to the quality, the efficiency and the effectiveness of public health services.
  • CYNMA believes that Nursing and Midwifery Associations in each Country must try to assist nursing and midwifery staff to build and to develop certain knowledge skills and attitudes that could better equip them, to deal with their important Public Health role.
  • CYNMA believes that patients, relatives, carers, and significant others can also play an important role in public health. Therefore, Nurses, Midwives and Health Visitors not only should be equipped with such skills knowledge and attitudes in order to teach these stakeholders regarding health issues, but also to encourage their active contribution to Public Health.
  • CYNMA believes that the Nursing and Midwifery contribution in public health services can be attributed into four major parameters.
    • Nurses, Midwives and Health Visitors acting across a range of settings from surgery to learning disabilities or in the general health arena as health-promoting practitioners  maximizing  health  outcomes  for  individuals  and  carers.  For example, nurses working on a preoperative or postoperative units, by developing a shared approach with patients relatives or significant others, could have strong impact not only on the immediate patient surgery and treatment but also on the patient’s and family health status, into the future.
    • Nurses Midwives and Health Visitors acting mainly in the Community, with roles that include specific primary and secondary prevention as well as treatment responsibilities. For example, Nurses Midwives and Health Visitors, with key roles in screening, or vaccinations who enable people to  remain healthy and support self- possession, when pathological conditions do arise. Other examples are community nurses and community midwives who have responsibilities regarding health individuals and the wider community in a cost-effective, preventing and health promoting way.
    • Nurses Midwives and Health Visitors can make a significant impact and on health inequalities. For example, Nurses Midwives and Health Visitors working on individual and population approaches for those with mental health conditions and in learning disability services towards bridging the inequality gap.
    • Nurses  Midwives  and  Health  Visitors  with  specific  training  in  community nursing, and/or public health nursing with specific responsibilities for population health through various community and health education programmes.
  • CYNMA believes that the effort for promoting and improving health outcomes requires joined-up   approaches   between   health   authorities,   health   professionals   and   their
  • associations, local governments and communities. Approaches based on factors that develop resilience and promote positive health and wellbeing should be promoted with this joined-up approaches.
  • CYNMA believes that Nurses Midwives and Health Visitors  should lead certain public health programmes with the aim to develop skills that support capacity building in local
  • communities for improving health and wellbeing.
  • CYNMA  believes  that  through  adopting  a  healthier  lifestyle  themselves,  Nurses Midwives and Health Visitors could be the society’s role model for what is conceived as the norm, healthy and good example to follow.
  • CYNMA believes that Nurses Midwives and Health Visitors are a vital link between medicine and public health. To measure the impact of certain Public Health approaches an Outcome Framework can be developed across five domains:
    • Health  Protection  and  Resilience:  Set  rules  and  regulations  to  protect  the population’s health from major emergencies in order to remain resilient to harm
    • Tackling the factors that affect health and wellbeing and health inequalities, i.e. the wider determinants of health.
    • Health Improvement of the population: Provide assistance to people in order to live healthy lifestyles, make healthy choices and reduce health inequalities.
    • Prevention  of  ill  health:  Reduction  in  the  number  of  people  living  with preventable diseases or ill health – Reduction of health inequalities in all levels of health services
    • Increase  life  expectancy  with  good  health  and  wellbeing  and  reduction  of mortality rate – Measures to prevent people from dying prematurely and to reduce health inequalities.