Global standards for the initial education of professional nurses and midwives

Nursing & Midwifery
Human Resources for Health
Global standards
for the initial education
of professional nurses
and midwives

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Global Standards for the initial education of professional nurses and midwives (WHO/HRH/HPN/08.6)
This publication was produced by the Department of Human Resources for Health, World Health
Organization.
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Nursing & Midwifery
Human Resources for Health
Global standards
for the initial education
of professional nurses
and midwives
Geneva 2009

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Contents
Acknowledgements
4
Part one
7
Background
8
Goal of the global standards
10
Intended use of standards
12
The context
14
Process and methodology
16
Part two
18
Standards for nursing and midwifery initial education
19

Principles
19

1.0 Programme graduates
20

2.0 Programme development/revision
22

3.0 Programme curriculum
24

4.0 Faculty
26

5.0 Programme admission
28
Part three
30
References
31
Annex: List of respondents
32
Glossary
35
3

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Acknowledgements
The World Health Organization (WHO) gratefully acknowledges the ex-
pertise, time and contributions of all those who engaged in the develop-
ment of these global standards, enriching the procedure with their collec-
tive wisdom, intellectual input and the shared experience of their diverse
organizations.
WHO is particularly grateful to the members of the Task Force on Global
Standards in Nursing and Midwifery Education who contributed their exper-
tise and resources over countless hours and worked with vision and com-
mitment to bring this initiative to completion: Dr Fariba Al-Darazi (WHO
Regional Office for the Eastern Mediterranean), Dr Sawsan Al-Majali (Nurs-
ing Programme, Dar Al-Hekma College), Ms Nancy Dickenson-Hazard
(Sigma Theta Tau International), Dr Valerie Fleming (Glasgow Caledo-
nian University, WHO Collaborating Centre for Nursing and Midwifery),
Dr Karen Morin (University of Wisconsin, Milwaukee), and Dr Jean Yan
(World Health Organization).
WHO also extends sincere appreciation to the individuals and organizations
that participated in the following meetings.
Developing Global Standards for Initial Nursing and Midwifery Educa-
tion, Bangkok, Thailand, December 2006:
Dr Sawsan Al-Majali (The Global Advisory Group for Nursing and Mid-
wifery – Advisers for Nursing and Midwifery), Dr Jean E. Bartels (Ameri-
can Association of Colleges of Nursing), Mr David C. Benton (International
Council of Nurses), Dr John Daly (Council of Deans of Nursing and Mid-
wifery, Australia and New Zealand), Ms Nancy Dickenson-Hazard (Sigma
Theta Tau International), Dr Majeda Mohammed El-Bana (Scientific Asso-
ciation of Arab Nursing Faculties), Dr Valerie Fleming (WHO Collaborat-
ing Centre for Nursing and Midwifery Development, Glasgow Caledonian
University), Dr Kathleen Fritsch (WHO Regional Office for Western Pa-
cific), Ms Andrea E. Higham (Johnson and Johnson), Ms Anne Hyre (Johns
Hopkins Program for International Education in Gynecology and Obstet-
rics), Ms Lennie Adeline Kamwendo (Association of Malawian Midwives),
Dr Shaké Ketefian (International Network for Doctoral Education in Nurs-
ing), Dr Siriporn Khampalikit (Thammasat University, Faculty of Nursing),
4
Global standards for the initial education of professional nurses and midwives

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Dr Wipada Kunaviktikul (WHO Collaborating Centre for Nursing and Mid-
wifery, Chiang Mai University), Dr Lynnette Leeseberg Stamler (Canadian
Association of Schools of Nursing), Mrs María Paz Mompart García (Asoci-
ación Latino Americana de Escuelas y Facultades de Enfermería), Dr Karen
Morin (Sigma Theta Tau International), Dr Barbara L. Nichols (Commission
on Graduates of Foreign Nursing Schools), Dr Kobkul Phancharoenworakul
(WHO Collaborating Centre for Nursing and Midwifery Development, Fac-
ulty of Nursing, Mahidol University), Dr Rutja Phuphaibul (WHO Collabo-
rating Centre for Nursing and Midwifery Development, Faculty of Nursing,
Mahidol University), Dr Richard W. Redman (International Network for
Doctoral Education in Nursing), Dr Darunee Rujkorakarn (Chair of the
Consortium of Deans and Heads of Nursing Educational Institutes, Chair of
the Accreditation Committee for Nursing Educational Institutes Thailand),
Dr Ellen Rukholm (Canadian Association of Schools of Nursing), Dr Maria
Teresita Sy-Sinda (Silliman University, College of Nursing and Allied Health
Science), Dr Nenita P. Tayko (Foundation University, College of Nursing,
Philippines), Dr Josefina A. Tuazon (WHO Collaborating Centre for Lead-
ership in Nursing Development, University of the Philippines, Manila),
Dr Kim Usher (Council of Deans of Nursing and Midwifery, Australia and
New Zealand), and Dr Jean Yan (World Health Organization, Geneva).
Task Force Meeting on the Global Standards for Initial Nursing and Mid-
wifery Education, Glasgow, Scotland, November 2007:
Mrs Fadwa Affara (International Council of Nurses), Dr Sawsan Al-Majali
(Global Advisory Group for Nursing and Midwifery – Advisers for Nurs-
ing and Midwifery), Ms Nancy Dickenson-Hazard (Sigma Theta Tau In-
ternational), Dr Valerie Fleming (Global Network of WHO Collaboarting
Centres on Nursing and Midwifery Development), Dr Karen Morin (Sigma
Theta Tau International), Ms Nester Moyo (International Confederation
of Midwives), Dr Bente Sivertsen (WHO Regional Office for Europe), and
Dr Jean Yan (World Health Organization, Geneva).
WHO also wishes to acknowledge the contributions of:
Mrs Margaret Phiri, Regional Adviser for Nursing and Midwifery (AFRO),
Dr Prakin Suchaxaya, Regional Adviser for Nursing and Midwifery (SEARO),
Dr Silvina Malvarez de Carlino, Regional Adviser on Nursing and Allied
Health Human Resources (EMRO)
Global standards for the initial education of professional nurses and midwives
Acknowledgements
5

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WHO is grateful for the valuable resource material provided by the World
Federation of Medication Education in its publication: Basic Medical Educa-
tion: WFME Global Standards for Quality Improvement (University of Co-
penhagen, Denmark, 2003).
Furthermore, WHO gratefully acknowledges the generosity of the organiza-
tions that provided external funding support: the American Association of
Colleges of Nursing, the Campaign for Nursing, and the Council of Deans
and Heads of University Faculties for Nursing and Allied Health Professions
in the United Kingdom.
In conclusion, WHO acknowledges and appreciates the contribution of all
the individuals and institutions that reviewed the standards and provided
feedback.

6
Global standards for the initial education of professional nurses and midwives

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Part one
Global standards
for the initial education
of professional nurses
and midwives

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Ba
B ck
a gr
ck o
gr u
o n
u d
n
An estimated 35 million nurses and midwives make up the greater part of
the global health-care workforce (1). Nurses and midwives make a substan-
tial contribution to health-delivery systems in primary care, acute care and
community care settings. However, despite this, they are seldom involved
in policy development for human resources for health or in high-level stra-
tegic decision-making. In many countries this may be due to the perceived
status of nurses and midwives; it could also be a result of the general level
of education of the profession (2).
In 2001 the World Health Assembly (WHA) supported the cal to strengthen
the nursing and midwifery professions by passing resolution WHA54.12,
validating WHO’s commitment to the scaling-up of the
health professions. This resolution specifically estab-
An estimated 35
lishes the imperatives: a) for Member States to give
mil ion nurses and
urgent attention to ways of improving nursing and
midwives make up
midwifery in their respective countries, and b) for the
Director-General to prepare an action plan, with inbuilt
the greater part of
evaluation procedures, for strengthening nursing and
the global health-
midwifery services (3). The Strategic Directions for
care workforce.
Strengthening Nursing and Midwifery Services 2002–
2008 (4), served as a blueprint for the subsequent
implementation of the resolution. A further resolution,
WHA59.23, (5) stresses the development of global standards for initial educa-
tion as a priority activity in strengthening nursing and midwifery services in
order to achieve the Millennium Development Goals (MDGs) for health (6).
The need for global standards has arisen for several reasons – the increas-
ing complexities in health-care provision, the increasing number of health
professionals at different levels, and the need to assure more equitable
access to health care. The great variation in the levels of initial education
(see Glossary) for professional nurses and midwives around the world can
no longer be neglected. Many countries still consider initial education pro-
grammes at secondary school level to be sufficient, while some countries
specify university-level education as the minimum point of entry to the
health professions for nurses and midwives (in practice, university-level
education is more frequently specified for nursing than for midwifery).
Despite slow beginnings, the move to raise the qualification requirements
of initial education programmes for professional nurses and, in some cases
8
Global standards for the initial education of professional nurses and midwives

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