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Chapter 15:
Nursing and Global Health
Copyright © 2016 Wolters Kluwer Health | Lippincott Williams
& Wilkins
Copyright © 2016 Wolters Kluwer • All Rights Reserved
1
Introduction to Global Health #1
Global health: the challenges to and opportunities for health and
well-being that transcend national borders, have broad
socioeconomic and political impact, and are best addressed by
coordinated, multinational efforts.
Regardless of where nurses work, global health issues will have
an impact on their work to some degree.
Example: 2014 Ebola outbreak

2
Lack of Human Resources for Health Globally
Three major processes contribute to the shortage of health care
workers, including nurses:
insufficient supply
inadequate distribution
migration
International nurses working in global health will frequently
encounter local complementary and integrative health and
traditional remedies, including
Traditional Birth Attendants (TBAs): a person whose cultural
role it is to attend to women before, during, or after childbirth
Traditional Healers: community members who are recognized
for their ability to use physical, spiritual, and/or herbal
modalities to treat illness
Question #1

Is the following statement true or false?
Utilizing Traditional Birth Attendants in communities
optimizes better outcomes for mother and child.
Answer to Question #1
False
Rationale: Maternal and neonatal mortality is higher when the
only birth attendant is a TBA. Historically, this has been due to
a lack of sterile or clean technique or a lack of knowledge
regarding prevention of common childbirth complications.
Global health nurses often train TBAs in evidence-based
maternity care in order to reduce maternal and neonatal
mortality.
There are large disparities in health and well-being at the global
level, which result from complex political and economic
processes.
Over the past 50 years, significant efforts have been made to
improve the well-being of people living in low-income
countries.
Maternal and child health interventions
Water and sanitation improvements
HIV/AIDS prevention and treatment

Millennium Developmental Goals
A worldwide commitment to reduce extreme poverty is led by
the United Nations Millennium Declaration, 2000.
Organized under 8 goals known as the Millennium Development
Goals (MDGs). Each goal has a series of time-bound targets
with a deadline of 2015.
The three related to global health are to:
Reduce Child Mortality
Improve Maternal Health
Combat HIV/AIDS, Malaria, and Other Diseases
Key Concepts in Global Health and International Nursing
Effective partnerships between foreign and local nurses can
result in creative, evidence-based, appropriate, and sustainable
solutions to local healthcare challenges.
Sustainability means that once a project is completed, its results
can be maintained by the community or government without
further outside input.
Other concepts include availability, accessibility, and
acceptability.
Question #2
Which of the following key concepts in global health may be
concerned with individuals fearing stigma?
Partnerships
Sustainability

Availability
Accessibility
D. Accessibility
Rationale: Accessibility means that the people for whom the
product or service is intended are able to obtain it.
One critical element of accessibility is stigma; do people fear
using the product or service because it might stigmatize them in
their community?
The Global Public Health Sector
Multilateral organizations: collaborative effort among many
different countries with a shared purpose
The World Health Organization (WHO), the United Nations
(UN)
Bilateral organizations and donors: governmental organizations
responsible for investing in development programs in lower-
income countries
Nongovernment organizations (NGOs): nonprofit development
organizations, civil society organizations, faith-based
organizations, universities, and for-profit contracting firms
The Nurse in Global Public Health

In the realm of international health, nurses play various roles:
as advisors, trainers, program managers, researchers, and
humanitarian response workers.
In all of these roles, transcultural nursing skills are essential to
success, as they all require the ability to communicate, work,
and adapt interventions to cultures different than one’s own.
Preparing for a Career in International Nursing and Global
Public Health
Nurses working outside their home countries should have
certain knowledge, skills, and attitudes to ensure their success:
Knowledge of history, international and community
development, and the culture in their host country
Strong transcultural nursing skills
Attitudes that facilitate professional success: willingness to
live in less than comfortable conditions; openness to the
perspective of others; flexibility; and energy to take
personal risks to advocate for social justice and achieve
morally sound outcomes
Getting Started in International Nursing and Global Public
Health
The best way to get started in international nursing is through
long-term volunteer work with an organization
Developing an appropriate skill set in their own country
Academic preparation; studying and researching transcultural
nursing

Some nurses support global health by providing financial
support to an organization that works in this field.
Other Nursing Roles Internationally
Medical missions
Short-term assignments
Military nursing
Long-term volunteerships
Question #3
Is the following statement true or false?
One way a nurse may develop his/her skill set in their own
country is by learning a new language.
True
Rationale: Developing a skill set in their own country may
include learning a new language.
Many of the same skills needed for international nursing are
useful when working transculturally at home.

18

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