Nursing and midwifery in a changing world: Addressing planetary health and digital literacy through a global curriculum

摘要

In May 2023, the World Health Organization declared an end to COVID-19 as a global health emergency. The COVID-19 pandemic exacerbated shortages of nursing and midwifery workforces and promoted their mobilization and migration globally. Since nurses and midwives play a critical role in health promotion, disease prevention and delivery of health care, equipping them with planetary health and digital literacy is crucial for a responsive workforce in the 21st century. In this editorial, we discuss the importance of planetary health and digital literacy in nursing and midwifery education in an era with high nursing and midwifery mobility. We aim to raise further discussion among stakeholders on the potential of global curricula for the education of nurses and midwives internationally. Global nursing and midwifery workforce shortage is a critical issue to meet the demands of population health. According to the World Health Organization (2021a), the global nursing workforce of 27.9 million accounts for a needs-based shortage of 5.9 million nurses. Almost 90% of the global nursing shortage is in low- and lower-middle-income countries. In contrast, about 70% of the projected increase in nursing workforce will occur in upper-middle and high-income countries by 2030. A similar picture of shortage of midwifery workforce is seen in low- and lower-middle countries. The global nursing and midwifery workforce accounts for nearly 50% of the global health workforce. Meanwhile, the global shortages of nursing and midwifery also account for 50% of the current shortage in health workers (World Health Organization, 2021a). Exacerbated workforce shortages after the COVID-19 pandemic have resulted in negative consequences on population health, such as cessation of non-critical healthcare services and inadequate coverage of health services in rural areas. To alleviate negative impacts of manpower shortage, various developed countries, such as Australia and Canada, highly prioritized nurses and midwives in their wanted skills lists for immigration. Globally, one in eight nurses migrate to work in another country where they were not born or educated (World Health Organization, 2021a). In most cases, foreign-educated nurses coming from low- and lower-middle-income countries moved to high-income countries for higher wages. It was suggested that international nursing and midwifery workforce mobility and migration actually further increased after the COVID-19 pandemic because of greater demands for workforce from high-income countries, as well as relaxed barriers to international travel or entry into practice (World Health Organization, 2021a). The international migration of nurses and midwives implies there is an increasing diversity among the workforce. For example, the nursing and midwifery curricula of the origin countries may only satisfy the domestic needs of the origin countries. Although foreign-educated nurses need to fulfil the registration requirement of host countries, the content of the examination is usually still country-specific. A more comprehensive global education programme is essential to prepare the nurses for working both domestically and internationally. The health of our planet is intricately linked to human well-being, and it is crucial that nurses and midwives recognize the urgent need to address climate change. Climate change has been identified as one of the most statistically significant health challenges we face in the 21st century (Campbell-Lendrum et al., 2023). It is not only responsible for more than one-third of heat-related deaths and proliferation of infectious diseases, but also contributes to the rise of non-communicable diseases, including mental disorders (Vicedo-Cabrera, 2021). In addition, the choices we make in terms of development and economy directly impact the climate crisis, which in turn affects our health reciprocally. For instance, urbanization often contributes to global warming and physical inactivity, l