Nursing leadership in health care: WHO nursing midwifery services strategic directions.

In the end of the XXI century, one may observe a movement strengthening nursing that is reflected in several WHA resolutions, recognizing the importance and the strategic character of nursing actions among the health professions. The formation of a Global Network of Collaborating Centers linked to WHO formalizes these changes and consolidates the link of nurses with the Organization’s directions. This process resulted in the establishment by WHO of the Nursing Midwifery Services Strategic Directions, with the purpose to facilitate nurses’ leadership in health care and promotion and, consequently, to search for innovative ways to enable an efficacious management of the health services. In addition, it is important to emphasize the concept of “leadership of impact” based on the idea that “leadership is not a position, but a way of thinking and of acting that influences other persons”. Thus, in their clinical and academic practice, nurses must search to perform a leadership of impact, initiating and being responsible for changes in health care delivery. The Strategic Directions defined by WHO in 2002 officialize this relevant role attributed to nurses, focusing the following areas: 1. Health Planning, advocacy and political commitment regarding national development through the delivery of nurses and midwifery services. 2. Management of health personnel for nursing and midwifery with the establishment of policies on nursing and midwifery workforce that are gender-sensitive, based on healthy and safe work environments. 3. Practice and Health System improvement, integrating nurses in the decision making processes at all levels. 4. Education of health personnel for nursing and midwifery services, capacitating them to face the future challenges of their professional practice. 5. Support to nursing and midwifery services including government, civil society and other health professionals. In order to implement these orientations, WHO and other international organizations that are members of UN System are willing to strive to assure the recognition of nursing and midwifery services as fundamental to the improvement of health care in general, adapting these directions to the characteristics and specific development needs of different countries. The joint actions of governments and societies are essential for the implementation of actions directed to the constructive capacitation of nursing professionals, to stimulate the development of evidence based practice and the formation of effective leaderships among nurses. To meet these goals is a great challenge to Nursing in this new millennium.