report on the south pacific chief (spcnmoa) meeting on the south pacific chief nursing and midwifery...

Report on the South Pacific ChiefNursing and Midwifery Officers Alliance(SPCNMOA) Meeting

Pacific partnerships working towards healthysystems and services in primary health care

7-9 April 2008Sydney, Australia

[ Report on the South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA) meeting ]ii

iii[ Pacific Partnerships Working Towards Healthy Systems And Services In Primary Health Care ]

Table of Contents

Page

Message from Mrs Rusieli Taukei, iv

1.Introduction 1

Participants 1

Objectives 2

Expected Outcomes 2

Thematic Overview 2

Welcome address and opening remarks 3

2. Proceedings 4

Summary of sessions: Day 1, Tuesday 8th April 4

Summary of sessions - Day 2, Wednesday 9th April 11

3. Conclusions 22

4. Annexes

Annex 1 - List of meeting participants, speakers, facilitators 24

Annex 2 - Meeting Agenda 27

Annex 3 - South Pacific Chief Nursing and Midwifery Officers Alliance:

Constitution 30

Annex 4 - SPCNMOA 2008 resolutions 34

Annex 5 - Action plan resulting from SPCNMOA meeting 2008 37

[ Report on the South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA) meeting ]iv

Message from Mrs Rusieli Taukei, Acting Director, Nursing & Health System Standards, Fiji

Ni sa bula vinaka.

It was indeed an honour and a privilege for me as Fiji’s Chief Nurse to chair the third South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA) meeting which was held in Sydney in April 2008 to coincide with the launch of the World Health Organisation Collaborating Centre for Nursing, Midwifery and Health Development at the Faculty of Nursing, Midwifery and Health, University of Technology Sydney (WHO CC FNMH, UTS). The SPCNMOA again wishes to congratulate the UTS on this great achievement, and we wish you every success for the future.

The participation of 38 delegates from sixteen countries of the South Pacific comprising Government Chief Nurses and educational representatives; WHO representatives from the region, the President of the American Pacific Nursing Leaders Council, staff of the FNMH at UTS, and notable observers and speakers no doubt made the two-day meeting an interesting, informative, fruitful and an enjoyable one. It was indeed an eye-opening and great learning experience for many of us who were attending the forum for the first time.

The interesting discussions, resolutions and achievements of the April 2008 meeting would certainly be of great benefit to nursing, midwifery and health development in the Pacific.

May I take this opportunity to sincerely thank the organizers and secretariat of the third SPCNMOA Meeting for their tireless effort, sacrifice and hard work in planning and organizing this meeting which proved to be a great success?

On behalf of all delegates, particularly from the Pacific Island countries, I wish to acknowledge and thank the WHO and AusAID for your sponsorship and funding assistance which enabled most, if not all member countries to be represented at the April 2008 Sydney meeting. In particular, I wish to thank Ms Kathleen Fritsch and staff of the WHO WPRO in Manila, WHO staff of the South Pacific offices and staff of the WHOCC FNMH, UTS for your assistance and facilitation for the 2008 SPCNMOA meeting.

It is my prayer that the good Lord will continue to shower his blessings upon the SPCNMOA and its members and I wish the Alliance every success for the future.

Vinaka vakalevu.

Mrs Rusieli TaukeiA/Director Nursing and Health System Standards, Fiji

�[ Pacific Partnerships Working Towards Healthy Systems And Services In Primary Health Care ]

1.Introduction

The third meeting of the South Pacific Chief Nursing and Midwife Officers Alliance (SPCNMOA), co-planned and co-sponsored by the University of Technology, Faculty of Nursing, Midwifery and Health World Health Organisation Collaborating Centre (UTS FNMH WHO CC) and the WHO Western Pacific Regional Office, was held in Sydney from 8-9th of April 2008. SPCNMOA requested that the meeting be held at UTS to coincide with the launch of the UTS FNMH, WHO CC for Nursing, Midwifery and Health Development (NMHD). The launch was held on the 7th April, 2008. Part of the remit of the WHO CC NMHD is to undertake the role of SPCNOA Secretariat. The meeting was also supported in part by AusAID.

The SPCNMOA meeting sought to build on the success of previous meetings held in the Cook Islands, 2004 and in Samoa 2006.This included work to strengthen the regional CNO network and regional relationships in-line with AusAID’s designated policy for assistance in health development as outlined in ‘Helping health systems deliver’ (AusAID, 2006) and to develop policies for regional priorities and goals.

Since the previous Alliance meeting, a World Health Organisation Western Pacific Region (WHO WPR) Regional CNO’s Leadership Summit: Building Leadership Capacity and Disease Prevention in the Region was held. This was convened by FNMH UTS and attended by regional Chief Nurses. The aims of the Summit were to bring together the Chief Nurses of the Western Pacific region to refine the WHO WPRO regional strategic plan for nursing and midwifery; to strengthen regional nursing and midwifery leadership and to discuss key public health issues such as pandemic preparedness, disaster management and human resources for health. The 2008 SPCNMOA meeting provided an opportunity to build on this work.

Participants

The SPCNMOA meeting was held in Sydney and attended by 38 delegates from 16 South Pacific countries. Delegates were Chief Nurses or Chief Nurses and Midwives, educational representatives and WHO regional and staff. Educational representatives were invited as discussions at previous meetings had focused on matters for which input from education providers would be of value. A full list of participants is given in Annex 1.

The meeting was organised by the FNMH UTS, WHO CC NMHD and the WHO regional office. The meeting was chaired by the Fiji Chief Nurse, Mrs Rusieli Taukei.

[ Report on the South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA) meeting ]�

Objectives

1. To launch the WHO CC NMHD to an invited audience and media representatives. To promote and celebrate the past and future work of the new WHO Collaborating Centre.

2. To facilitate the SPCNMOA meeting to operationalize the WHO /Pacific Regional Strategic Plan for Nursing and Midwifery and to review the indicators for the WHO Nursing Midwifery Services Strategic Directions for 2008-2015.

3. To develop leadership capacity and succession planning for chief nurses within the region.4. To facilitate the sharing of experiences of pandemic preparedness and disaster planning.5. To strengthen regional governmental networks to improve crisis communication, crisis

management and leadership in the face of regional threats.

The meeting agenda is in Annex 2.

Expected Outcomes

The expected outcomes were as follows:• A finalized Alliance constitution;• Review of the regional Pacific strategic plan for WHO/WPRO Nursing and Midwifery and

delineation of core action areas for SPCNMOA in relation to this work;• An enhanced network of CNOs within the Pacific Island Nations and increased knowledge of

building leadership capacity;• An improved understanding of the impact of pandemic preparedness and disaster

management and agreement on related core actions areas for SPCNMOA; • Increased understanding of the impact of differing regional educational standards on nursing/

midwifery service quality; • Agreement on core action areas to address these issues;• Consultation on WHO Bi-Regional Minimum Data Set and HRH Country Profiles project

(Phase II);• Development of a work programme for the Alliance;• A formal meeting report to be written and disseminated to all participants.

Thematic Overview

The two-day meeting was structured by different themes (see Annex 2).

During Day 1, the focus was on core Alliance business. This included adoption of the 2006 Meeting Report and resolutions, finalisation of the SPCNMOA Constitution, drafting the SPCNMOA action plan and analysing country data.

The second day consisted of presentations which were grouped by the headings: Financing and


medical products/technologies; Health workforce and information; Service delivery and leadership/governance and finalisation of SPCNMOA business.

The headings reflect the six building blocks discussed in the WHO document Everybody’s Business: Strengthening Health Systems to Improve Health Outcomes (WHO, 2007). This document presents a framework consisting of the building blocks thought to represent the core features of a health system aimed at improving efficiency and health. These building blocks are:1. Financing;2. Health workforce;3. Information;4. Medical products and technology;5. Service delivery;6. Leadership/governance. Welcome address and opening remarks

SPCNMOA Chair, Mrs Rusieli Taukei, Chief Nurse, Fiji, Professor Denise Dignam, Acting Dean, Faculty of Nursing Midwifery & Health (FNMH), University of Technology Sydney (UTS)

The meeting commenced with a welcome and a round of introductions of delegates and observers. The SPCNMOA 2008 Chair, Mrs Rusieli Taukei (Chief Nurse, Fiji) welcomed the President of the American Pacific Nurse Leaders Council, Mrs Toaga Seumalo. The eight educational representatives were thanked for attending the meeting.

Mrs Taukei explained that the 2008 meeting of the Alliance had to be held in Sydney not Fiji as planned. She thanked UTS for its hospitality and also the FNMH UTS WHO CC NMHD secretariat for organising the meeting. She spoke of the great achievement for the region of the launch of the WHO CC NMHD. Mrs Taukei explained that part of the business of the 2008 meeting is to operationalise the WHO strategic plan, to consider strategies related to Human Resources for Health (HRH) and for strengthening primary health (PHC), to finalise the SPCNMOA Constitution, to strengthen the network and to develop an action plan for the Alliance. Mrs Taukei thanked Mrs Stowers for her support and also the WHO; FNMH UTS WHO CC NMHD; and New Zealand.

Professor Denise Dignam also greeted the delegates and said that the FNMH UTS was delighted to provide secretariat support to the Meeting and thanked WHO CC NMHD staff for organising the Meeting.


2. Proceedings

Summary of sessions: Day 1, Tuesday 8th April

Morning Chair: Mrs Rusieli Taukei, Chief Nurse, Fiji

Session 1: Objectives & structure of Meeting – WHO Strategy and WHO Action FrameworkMs Kathy Fritsch, WHO Western Pacific Regional Office (WPRO) Nurse Adviser

Ms Fritsch welcomed delegates and presented the meeting objectives which included launching the WHO CC NMHD. She explained that the WHO CC is under the auspices of WHO and FNMH, UTS. This is a huge step forward for the region and will provide a central point of co-ordination for several projects.

The other main objective was to operationalise the WHO Pacific/Regional Strategic Action Plan for Nursing & Midwifery, including a review of the indicators in the global report by WHO Strategic directions for strengthening nursing and midwifery services.

Ms Fritsch outlined the expected outcomes of the Meeting as outlined on page 6.

Session 2: Adoption of the 2006 Meeting report: resolutions Mrs Pelenate Stowers, Chief Nurse, Samoa and Mrs Rusieli Taukei, Chief Nurse, Fiji

Mrs Stowers summarised the two resolutions (p 34 & 35 of SPCNOA 2006 Report) of the previous meeting, which were: 1. Support for enhancing and standardising nursing and midwifery education programmes in

the WPR2. Support for a strategic action plan for nursing and midwifery development in the PIC.

The Meeting endorsed the 2006 SPCNOA report and resolutions. Session 3: SPCNMOA Constitution Ms Michele Rumsey, WHO CC Nursing, Midwifery and Health Development

In Mr Clark’s absence due to ill-health, Ms Rumsey led Session 3.


To introduce the session, Ms Rumsey spoke to the document Executive Summary Strategic Plan for Strengthening Health Systems in the WPR. She explained that the WHO Regional Office would like SPCNMOA to be involved in the strategic planning. The document outlines a new method of project development. This emphasises vertical and horizontal streams of activity and the systems required to build capacity and strengthen health systems and consists of the building blocks outlined on page 6 above.

These building blocks should be considered when planning health-focused programs or projects and should therefore should be considered when new initiatives are proposed during the SPCNMOA discussions.

Ms Rumsey then spoke to the draft SPCNMOA Constitution. She explained that the most recent version had been developed from the draft produced after the 2006 Samoa meeting. It had been revised following input from the SPCNMOA planning committee meetings. Mr Clark and Ms Rumsey have incorporated these comments and revised the Constitution to its present form. The draft Constitution was then discussed in detail by the Meeting. It was agreed that the Constitution would undergo further revisions by a small working group following the morning’s input and be presented for review and final endorsement on Day 2.

Afternoon Chair: Ms Iokopeta Ngari, Nurse Manager, Cook Islands

Session 4: Operationalisation of WHO/WPRO regional & Pacific Island Countries (PIC) Strategic Plan & WHO Nursing/Midwifery Strategic Directions consultation Ms Kathy Fritsch, WHO Western Pacific Regional Office (WPRO) Nurse Adviser

Ms Fritsch outlined the expected outcomes and strategic objectives as referred to in the document distributed at the meeting: WHO Strategic Action Plan for Nursing & Midwifery Development in the Pacific Island Countries (PIC). This document is aligned with the Regional Strategy on Human Resources for Health 2006-2015 and the WHO Strategic Action Plan for Nursing & Midwifery Development in the Western Pacific Region (the latter document was also distributed at the Meeting).

The plan emphasises improving health services and outcomes, and moves away from a sole focus on nursing. The regional HRH goal is to be responsive to population health needs and to promote equitable access to quality health services.

Ms Fritsch concluded Session 4 by saying that steps towards action are required to address key gaps and needs in health services. To improve health status and service delivery, a formal network is required in partnership with those we work with and serve.


Session 5: Pacific Human Resources Health Alliance (PHRHA) – Supporting Human Resources for Health (HRH) in Pacific Island Countries (PIC) Ms Monica Fong, Technical Officer, Human Resources & Health Systems Research, WHO

Ms Fong distributed copies of her presentation and the PHRHA Terms of Reference. Ms Fong gave an overview of the role of the PHRHA and a brief history of its development. The PHRHA was formed as a result of an urgent need to intensify efforts in addressing regional HRH issues. This need was identified by WHO during a consultation conducted in Suva, December 2007.

The key functions of the Alliance are to:1. Advocate for HRH in the Pacific and facilitate effective partnerships and coordinated

approaches.2. Serve as an HRH information hub for PIC, monitor workforce trends and strengthen national

HRH data and information systems. 3. Support knowledge generation, management and sharing.4. Facilitate HRH capacity building, quality of training institutions and networking. 5. Support HRH policy and strategy development, leadership and management in PIC.

Key regional challenges identified include: shortage of staff; inappropriate skills mix; insufficient numbers trained and insufficient investment in training institutions; dissatisfaction, poor remuneration and work conditions. A provisional work plan to address these challenges has been drafted. The workplan focuses on advocacy; the development of partnerships; providing an information hub on HRH information; supporting knowledge generation, facilitation of HRH capacity building and supporting HRH policy and strategy development, leadership and management in PIC.

PHRHA relationships have been formed with Ministries of Health, donors and other appropriate regional bodies. Thematic working groups conduct the work of the PHRHA. Currently, there is a focus on priority areas. These are: multiskilling and task shifting; migration and retention; strengthening training institutions; and strengthening systems for continuing education.

Ms Fong said that PHRHA have requested a SPCNMOA delegate to liaise with PHRHA. It was proposed by Mr Jones (New Zealand) and seconded by Mrs Stowers (Samoa) that SPCNMOA be affiliated with the PHRHA. The focal person will rotate and will be the current SPCNMOA Chair. Session 6: Country priority group discussions - Analysis of country templates Associate Professor Lin Lock, FNMH, UTS

Professor Lock explained that the country template was developed as a guide to enable concise reporting of key nursing/midwifery issues, priorities, activities and strategies which are linked to the key result areas (KRA) and strategic objectives (SO) of the WHO Western Pacific Regional human


resources for health (HRH) strategy and the global Strategic directions for strengthening nursing and midwifery services (Geneva, World Health Organization, 2002).

Templates for each of the fourteen countries represented at SPCNMOA were circulated prior to the meeting. The information in these templates will be updated before each SPCNMOA meeting. The country templates provide a tool by which to compare and chart regional developments.

The key result areas/strategic objectives are:

KRA 1: Health workforce response to population health needs (demand) SO 1: Ensuring that health workforce planning and development is an integral part of the national development plan and responsive to population and service needs.

KRA 2: Health workforce development, deployment and retention (supply) SO 2.1: Enabling the delivery of effective health services by addressing workforce size and distribution. SO 2.2: Addressing workforce needs, including the workforce environment, to ensure optimal workforce retention and participation.SO 2.3: Improving the quality of education and training to meet the skill and development needs of the workforce in changing service environments.

KRA 3: Health workforce governance and managementSO 3: Strengthening health workforce governance and management to ensure the delivery of cost-effective, evidence-based, quality and safe programmes and services.

Out of 14 countries, seven country templates were returned. Professor Lock summarised and analysed the returned templates and found that feedback clustered round professional, educational and workforce issues.

Educational: Feedback ranged from issues associated with entry to practice to advanced practice requirements. A recurring theme was the delayed implementation of competency standards.

Professional: Many mentioned the following as of concern: the development of CNO posts; professional recognition; restructuring of nursing positions; governance.

Workforce: In relation to workforce, issues identified included: migration; shortages; imbalances between HRH and population needs; retention; mismatch in supply/demand; lack of planning and an aging workforce.

Professor Lock explained that SPCNMOA has the opportunity to identify strategies to address some of these issues. Developing initiatives to address such issues also provides a means


to measure the contribution of the SPCNMOA in helping to produce positive health-related outcomes.

After the presentation, Professor Lock opened up discussion. The Meeting discussed each area and possible initiatives in respect of these three areas nominated by the delegates are presented as follows:

WorkforceWorkforce structures need to be designed/changed and country contexts need to be considered when implementing strategies to address workforce issues.

Education Teacher exchange programmes; twinning programmes for education; mentoring programmes for countries that do not have well established competencies; strengthen systems for the regular review of educational programmes; development of a common curriculum; processes for developing curriculum standards and competencies; working together for uniform requirements suitable for all countries.

Ms Fritsch said that the Mapping exercise had shown the importance of improving standardisation and the quality of nursing and midwifery education to safeguard the public. A number of institutions in Guam, Hawaii, and Philippines are working in partnership to do this.

Professional Continuing professional education; matching education and profession; need for WP/SEAR Regulatory Authorities (WP/SEAR) to investigate how reciprocity could be achieved with common competencies across and between island countries and New Zealand and Australia.

Session 7: Now more than ever: the contribution of nurses and midwives to primary health care - WHO Primary Health Care (PHC) Compendium Project Professor Mary Chiarella, FNMH, UTS

Professor Chiarella explained that as it is the 30th anniversary of the declaration of Alma Alta, there has been a revitalisation of interest in PHC and building on the legacy of Alma Alta. PHC is also the theme of International Nurses Day (Nurses Leading PHC) and World Health Day 2008. The WHO PHC project arose from Dr Jean Yan’s work to strengthen nursing and midwifery within the WHO. Professor Chiarella was requested to compile exemplars of nursing and midwifery work. The compendium and bibliography are in effect advocacy materials that highlight the contribution of nursing and midwifery in relation to PHC to the WHO and other agencies.

The compendium provides a snapshot of case studies of best practice from all six WHO regions and enables an examination of the common elements in successful PHC delivery. It will be launched as


a web-based resource. The foci of the case studies sit closely within the usual elements of PHC but some have expanded beyond traditional understandings of PHC. Examples include the growth of mental health services; the successful use of telehealth in developing countries; health promotion in relation to chronic diseases and the elderly; and preparation and support of PHS workforce.

An important point that emerged from this work included that the focus of PHC should be on prevention and early intervention. In most countries, there needs to be a refocus from a national illness system to a national health system.

The global award scheme which is to be launched in Thailand in 2008, aims to recognise the contribution of nursing and midwifery to PHC by sharing experiences, evidence and lessons learnt. Currently, there are 36 case studies from all WHO regions (in WPRO from Australia, the Cook Islands, Hong Kong, Korea and Samoa). Professor Chiarella requested more regional Nursing and Midwifery examples to be submitted to the award scheme.

SPCNMOA delegates were invited to comment on the project. Professor Chiarella encouraged delegates to submit award entries and to suggest key events where the Award might be promoted.

Session 8: Drafting of SPCNMOA Action Plan and relationship to the WHO Action Framework Professor Debra Thoms, Chief Nursing & Midwifery Officer, NSW Health and Mr Michael Larui, Director of Nursing, Solomon Islands

The final session for Day 1 focused on developing a 2-year action plan for SPCNMOA. This was done with reference to the documents WHO Strategic Action Plan for Nursing and Midwifery Development for Pacific Island Countries, page 22 and Everybody’s Business documents.

Delegates were invited to consider one or two projects that could address the points below included in the WHO Strategic plan for strengthening health systems in the WP region:

2.1 Research and policy option analysis implemented to develop:

• Evidence-based nursing/midwifery policies and workforce planning;

• Recruitment, scaling up and retention strategies;

• Management and performance enhancement strategies; and

• Supportive systems to enable health workers to work to their full scope of practice. The meeting was divided into three groups, each giving feedback on suggested projects.

[ Report on the South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA) meeting ]�0

Group 1 addressed the point Supportive systems to enable health workers to work to their full scope of practice. Key points included that education, policies, legislation and acts and limited scope of practice require addressing. Suggested strategies to be implemented within the next 2 years were updating regulation; making education accessible; a resource review; strengthening leadership training, skills development, mentoring and performance management. Over the long-term there needs to be legislation and regulation review; the establishment of supportive systems such as positive work environments and local solutions; setting up a nursing and midwifery exchange program.

Group 2 addressed the points Evidence-based nursing/midwifery policy and workforce planning and recruitment, scaling up and retention strategies. The group identified as important migration loss, staff shortages, need for implementation of evidence-based workforce planning policies; need for relevant qualitative and quantitative data to inform policy, skill mix, relationship between intake and service needs. Strategies included: attracting nurses back to home countries; addressing regulatory barriers for temporary registration; research on safe staffing and health outcomes; monitoring framework for workforce planning.

Group 3 addressed the first point Evidence-based nursing/midwifery policy and workforce planning. The following were identified as requiring addressing: accessing evidence; raising awareness of and sharing evidence; implementation of evidence. Suggested strategies were: establishment of a database in collaboration with APHRH; assistance with establishing an in-country focal person for HRH planning; introduction of research methods into the curriculum; computer education and identification of projects focused on building capacity that can be transferred into other settings.

This feedback was later summarized into four themes: regulation, education, leadership and data literacy. This feedback was discussed in more detail on Day 2.

At the conclusion of Day 1, Professor Thoms said that it was important that decisions made at the 2008 meeting are actioned. An action plan was developed (see Annex 5).

��[ Pacific Partnerships Working Towards Healthy Systems And Services In Primary Health Care ]

Summary of sessions - Day 2, Wednesday 9th April

Morning Chair: Mrs Ana Kavaefiafi, Chief Nurse, Tonga

Mrs Kavaefiafi welcomed the delegates to all to the last day of the meeting. The day commenced with a prayer and a hymn. It was explained that Day 2 presentations were organized around the building blocks presented on Day 1.

Financing and medical products/technologies

Session 1: Strategies for realistic donor involvement Ms Neti Herman, Former Chief Nursing Officer, Cook Islands; Ms Michele Rumsey, WHO CC NMHD; Mrs Pele Stowers, Chief Nurse, Samoa

A panel presentation was given on donor participation in the WPR.

Mrs Stowers said that for CNOs to make a national and regional impact they need to form relationships with development partners (donors) and to ensure that the latter respond to country needs. The new WHO CC NMHD will have a role in facilitating this objective. Another important factor is for CNOs to develop and influence in-country budgets.

Mrs Herman posed the question as to whether CNOs should contribute financially to assist the activities of SPCNMOA or the WHO CC NMHD. To do this, Ministries of Health need to be made aware of SPCNMOA financial support needs. It was agreed that delegates should raise this issue with their health ministers. Ms Rumsey advised that if countries make a financial contribution, SPCNMOA are able to inform donors that a partnership has been formed. This strengthens the case for funding.

Mrs Stowers said that delegates need to return to their countries and put in a proposal for financial assistance. It is the responsibility of each CNO to raise awareness amongst their ministries. SPCNMOA delegates could provide a briefing to their health minister outlining how the work of SPCNMOA will contribute to national health goals and copy in the WHO regional office.

Ms Fritsch stated that as WHO needs to maintain its neutrality CNOs need to follow up issues with their own ministries of health. Mr Clark informed the Meeting that in Papua New Guinea the nursing department gets involved in the health workplan and this provides a good opportunity to contribute and influence budget decisions. Ms Rumsey mentioned that a good opportunity to request financial support from Ministries of Health is when submitting yearly workplans.

[ Report on the South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA) meeting ]��

Mrs Seumalo (President of APNLC) informed the meeting that each American Pacific Nurse Leader Council (APNLC) delegate makes an annual contribution at a set rate to the Council.

Mr Jones said that it was essential that some funding is liberated for SPCNMOA. One way of doing this is to link the justification for funding to the need to address regional HRH issues. When the new Federal Australian CNO is in post, this is something that both New Zealand and Australia can work towards.

Session 2: AusAID Leadership Fellowship Awards Associate Professor Lin Lock, FNMH, UT and Ms Michele Rumsey, WHO CC NMHD

Ms Rumsey explained that the WHO CC NMHD can meet its objectives of regional capacity building with the support of the AusAID programmes. Proposals need to reflect SPCNMOA aims for capacity building and be supported by in-country Ministers of Health.

An outline was given of the Australian Leadership Awards (ALA) Fellowships. These fellowships aim to develop leadership and build partnerships with the Asia-Pacific region. ALA Fellowships are available for short-term study, research and professional attachment programs in Australia that are delivered by Australian organizations.

The aims of the awards are:• To develop appropriately trained current and aspiring leaders in Asia Pacific, who will be in a

position to advance key regional policy issues;• To build expertise and leadership around these issues;• To foster and strengthen links between Australian organizations and their counterparts in the

region.

Delegates were invited to propose ideas that would best help build capacity in each country. Ideas nominated by delegates included: • ALA fellowships; • HRH data analysis; • A higher education package that would fulfil the criteria under the AusAID scheme; • Utilisation of evidence across all spectrums of profession; • Strengthening regulatory systems and standards for service delivery; • Use of information, particularly HRH, by nurse leaders at all levels;• Exploring funding sources from New Zealand (not currently tapped into by Pacific Islands); and• Exchange programme between Pacific countries, particularly the small island nations.

As the next round of awards opens in July and closes in mid-August 2008, Ms Rumsey requested that delegates give this more thought and email ideas to the WHO CC NMHD, It was also agreed that the WHOCC will compile a compendium of all aid funding sources with criteria for what will be considered for funding under these schemes.


Session 3: Updates on other projects Ms Kathy Fritsch, WHO Western Pacific Regional Office (WPRO) Nurse Adviser and Mrs Pele Stowers, Chief Nurse, Samoa

Mrs Stowers gave a brief outline of the Global Advisory Nurse Group (GAG). The aim of GAG is to provide advice to the Director-General of WHO on how to enhance the nursing and midwifery contribution to WHO global and national priorities. Participants have to submit proposals to the World Health Asssembly in May 2008.

Ms Fritsch said that GAG is an important group for nurse leaders to network with because it provides direct policy advice to Dr Margaret Chan, the Director General of WHO.

Mrs Stowers informed the Meeting of a forthcoming meeting of CNOs and regulatory authorities to be held in Geneva and also of a meeting of the Global Health Forum. These are two meetings that the Alliance could become involved in and they provide a means of being linked into a global CNO network. The Health Professional Alliance precedes the World Health Assembly and it would be beneficial if SPCNMOA delegates could attend either or both meetings.

Ms Fritsch explained that although the WHO is operating in deficit and entering a new budgetary cycle, WHO Headquarters have set aside some money to support two nominees per region to attached the Global CNO meeting.

Mrs Stowers advised SPCNMOA delegates to return to their countries and assess whether any budget monies can be reprogrammed to allow attendance at these meetings. A convincing case needs to be made that attendance would have an impact on in-country policies and plans. The role of the Global Alliance of Nursing Education and Scholarship (GANES) was briefly explained by Mrs Stowers. GANES constitutes an international body which is aimed at developing strategies related to the education and professional development of nurses worldwide. Its membership comprises national associations of Nursing Deans and Schools of Nursing.

Session 4: Review of and agreement on the Constitution Ms Kathy Fritsch, WHO Western Pacific Regional Office (WPRO) Nurse Adviser

Members were invited to comment on the Consitution which had been redrafted following the previous day’s session on the Constitution. Further minor corrections were agreed and made as follows:

Vision All agreed to leave as in the revised draft. Moved: Mrs Ngari, Cook Islands; Seconded: Filomena MacKay, Fiji.


Mission Moved: Mrs Aiavao, Samoa; Seconded: Mrs Matariki, Vanuatu.

Values Dr McManus commented that ‘collaboration’ should be included as a value. Mrs Stowers and Mr Clark stated that a value is more a principle that underlies action and that the values should be left as written. Moved: Mrs Aiavao, Samoa; Seconded: Mrs Ngari, Cook Islands.

ObjectivesMoved: Mrs Roroi, Papua New Guinea; Seconded: Mrs Isom, Solomon Islands.

Working principles Moved: Mr Jones, New Zealand; Seconded: Mrs Leauma, Tuvalu.

Membership Moved: Mrs Stowers, Samoa; Seconded: Mrs Fereti, Niue.

Steering committee Moved: Mrs Isom, Solomons; Seconded: Mrs Tu’ipulotu, Tonga.

Secretariat Moved: Mrs Roroi, Papua New Guinea; Seconded: Neti Herman, Cook Islands

Decision-making Moved: Mrs Faafoi, Tokelau; Seconded: Mrs Mwareow, Nauru

Funding support The Meeting participants agreed to leave the wording as written.

The revised, finalised and endorsed Constitution is attached as Annex 3. Health workforce and information

Session 5: Report on Enhancing and Standardising Regional Training Programmes in Nursing Mapping Exercise – prepared for Pacific Islands Forum Secretariat (PIFS), SPCNMOA and WHO Ms Monica Fong, Technical Officer, Human Resources & Health Systems Research, WHO

Ms Fong presented the methodology and findings of the above report. This work was undertaken by Professor Kim Usher and her team from the James Cook University. The Forum Secretariat have requested feedback from SPCNMOA about the mapping exercise.


The terms of reference for the mapping exercise were as follows:

A situation analysis that will include coverage, content and qualifications of the courses and programmes offered by the various nursing educational institutions in a country.

This includes: 1. Review of curricula and training programmes, including descriptors of each course;2. An assessment of whether current training programmes meet specific regional guidelines,

standards and competencies and reflect practice of nurses in country;3. Assessment of graduate qualities;4. Assessment of country resources and ability to provide basic health care resources.

It was decided that the report on the Mapping Exercise be presented at the 2008 SPCNOA meeting and that this meeting will determine progression of the initiative on Enhancing & Standardizing Regional training programmes in Nursing – Phases 2 & 3.

Countries from both the North and South Pacific regions were included in the study. Data collection took place during the period May-June 2007. The study consisted of a literature review and analysis of three questionnaires focused on legislation, employment and nursing education. Telephone contact and onsite visits to Fiji and Samoa were done for the purpose of focus group interviews.

The report was completed in August 2007 (final report available at: www.forumsec.org). The Project Consultants recommended various initiatives be implemented in respect of legislation; workforce planning and education. These are summarised in the Executive Summary which was circulated at the meeting.

The main findings were as follows:• The data analysis of the material gathered demonstrated marked variability in the standards

of nursing education across the Pacific Island nations, thus supporting the views of the Chief Nursing Officers;

• Nursing curricula and training programmes vary considerably in relation to quality and that nurse education does not always currently meet specific regional needs for the provision of effective nursing practice;

• This is true for both basic/undergraduate nurse education and postgraduate nurse education (e.g. Midwifery courses range in duration from 6-24 months, and some postgraduate courses were reported as having no review or credentialing requirement);

• Wide variation exists in legislation, regulation, accreditation, salary structures and career pathways across the region;

• Competencies for Registered Nurse (RN) education and practice in the Western Pacific/South East Asia Region do exist; these were agreed at the meeting of the Western Pacific and


South East Asia Regulatory Authorities in Singapore, 2004 (WP/SEAR, Australian Nursing and Midwifery Council, 2006); and

• There is no evidence, however, that they are currently utilised widely as a framework for the development of RN nursing curricula or for the regulation of nursing practice within the PICs.

There were some limitations in design and methodology. These included that much depended upon the knowledge, willingness, time availability and integrity of the person completing the survey. In some countries questionnaires were not received. This was generally because the wrong focal person was identified, as the WHO information was out of date (this was the most common problem) or was out of the country and not able to access emails and unreliable email systems in the countries.

Professor Usher thanked all participants for contributing to the questionnaire.

The proposed Phase 2 of the project is dependent on the feedback from the 2008 SPCNMOA meeting on the draft scope, contents and mechanisms of standardising regional training programmes. Project activities will include convening a technical forum to identify, discuss and draft the scope, contents and mechanisms of standardizing identified regional training programmes. Mechanisms to ensure key stakeholders are familiar with and reasonably happy about the identified programmes will be established and there will be on-going consultation with each country.

Mrs Herman said that delegates should ensure that regional governments are informed of the outcomes of this study in order to demonstrate the importance of Phase 2. She also asked whether a role exists for the WHO CC NMHD in facilitating Phase II. Ms Fritsch said that a resolution was drafted for discussion in a later Day 2 session and this will address the progression of Phase 2.

Session 6: Human Resources for Health – health system priorities Ms Michele Rumsey, WHO CC NMHD

Ms Rumsey gave an overview of the project WHO Human Resources for Health Minimum Dataset (HRH MDS). This project is part of a broad strategy helping to address the major challenges faced by countries in the Western Pacific and South East Asia in building and sustaining health workforces. It was explained that this project has been carried out in collaboration and consultation with regional partners and steering committee. The first phase was carried out with individuals from 30 Western Pacific countries. During this phase, data elements were selected for inclusion in an HRH database and fact sheets developed to assist countries with using a minimum dataset package. The second phase will involve further development, testing and expanding of the HRH minimum data set to health professional groups.


The first fact sheet explains the importance of an adequate and evidence-based approach to HRH planning. The second fact sheet explains how to use the WHO HRH MDS and the third fact sheet outlines the indicators and domains which enable cross country comparison.

The second phase of the IMS project involves piloting HRH country profiles and assessment tools. Samoa and Vanuatu are involved in this pilot and SEARO countries will be involved at a later date.

Ms Rumsey explained that HRH MDS systems will only work if the following factors are in place: • Supportive ministry of health, ministry of finance, PSC and government;• HRH plans aligned with health sector plans;• Structures within the ministry that enable this to happen, eg., people and resources;• IT infrastructure and support;• Stakeholder involvement; and• Timelines and donor support.

There also needs to be clear agreement with stakeholders about who is responsible for co-ordinating the project; who stores, manages and controls access to the data; who is responsible for updating the data set; how the data will be secured and how any issues of data protection and privacy will be addressed. The sector-wide stakeholder group should include representatives from the private and public sectors, NGS, regulatory authorities, relevant Ministries including education.

Afternoon Chair: Mrs Filoimanatu Leauma, Acting Matron, Tuvalu

Service delivery and leadership/governance

Session 7: Asia-Pacific Emergency Disaster Nursing Network and OutcomesMs Lisa Conlon, FNMH UTS; Ms Keti Fereti, Principal Nursing Officer, Niue

Ms Conlon and Ms Fereti reported on the Asia-Pacific Emergency Disaster Nursing Network and Outcomes Meeting held in Bangkok, October 2007. The meeting objectives focused on key issues relating to health sector coordination in disaster preparation and response; identify methods to enhance collaboration; get agreement on structure and function of the network in the Asia-Pacific region; development of an action plan for the network and core curricular domains. Country case studies from PIC, China and Indonesia were used as the basis for discussion.

Outcomes from the meeting were:• Development of the charter for the Asia-Pacific Emergency and Disaster Nursing Network;• Development of an action plan for the establishment of a disaster nursing network;• Enhancement and development of close working relationships with senior regional nurses;• Information on lessons learned as a result of recent regional emergencies and disasters;


• Advancements made to develop a train-the-trainers course for emergency and disaster nurses;• Commencement of the development of a course for emergency and disaster nurses that will be

tailored to meet the specific requirements of individual countries; and• Working towards the next meeting to be held in Shandong, China, in October 2008

The session ended with delegates from Papua New Guinea and the Solomon Islands sharing recent experiences of meeting health needs in the wake of disaster.

Session 8: WHO Chief Nurse Leadership project - understanding the role of government officers and their relationship to the work of WHOProfessor Jill White, Dean, Faculty of Nursing & Midwifery, University of Sydney

Professor White reported on her work as a WHO nurse scholar. Professor White was invited by Dr Jean Yan (WHO HQ) to examine issues associated with the lack of recognition by WHO of the contribution of Government Chief Nurse and Midwife (GCNM) roles. The presentation commenced with setting the work in the current context of the health and service delivery issues faced by developing countries, and shortages of HRH and changing patterns of health care delivery.

Professor White explained that GCNMs should be included in health service decision making and policy planning. This is on the basis that so many health related projects, initiatives and strategies require coordination and commitment from professional groups through the GCNM. In addition, the GCNM has an integral role in workforce development for the largest component of the health workforce: recruitment, migration, retention, safe workplace, education standards and numbers, scope of practice, skill-mix, models of care especially in primary health care.

The GCNM also provides the government and policy link to professional organisations; regulatory authorities; accreditation authorities; and educational institutions.

The critical elements beyond leadership skills include possessing an understanding of public policy, political processes and the use of data to make a compelling case for change. This requires skills in information systems management, research and financial literacy, ability to be articulate with multiple audiences, self-confidence and professionalism. In essence, the GCNM role provides a bridge between programmes, government policy, health systems and services and professional silos.

Recent events have borne out the critical nature of and need for the GCNM role. For example, the SARS experience brought new respect for the GCNM role in China, Hong Kong and Singapore. However, the importance of the role primarily relates to the fact that in the most densely or most sparsely populated places on the earth nurses are health care and in other countries they are “the glue” that hold the health system together (60-70% globally and up to 85% in some countries).Professor White ended her talk with a quote: ‘The influence of nurses and midwives on health policies


and programs in their employment settings, communities and nations is inconsistent at best; at worst it is nearly absent at the formal public policy level ‘ (Busara Consultants, Canada, 2007, p.4).

Session 9: Group discussion - SPCNMOA 2008 Meeting resolutions Mr Mark Jones, Chief Nurse, New Zealand and Ms Tanimakin Nooti, Acting Director of Nursing Services, Kiribati

Mr Jones gave a presentation on the format and development of resolutions. Resolutions need to be practical and implementable and should consist of a preamble, declaration and recommendation. Resolutions can represent a tangible product of SPNCMOA’s deliberations, serve as a statement of resolve and present a declared position that we wish to share and would like others to act on.

Mr Jones then outlined possible areas for which SPCNMOA could make resolutions:• World Health Day – Climate change;• World Health Report 2006 – HRH; • World Health Report 2007 – Natural disasters; and• World Health Report 2008 – Primary health care.

The meeting divided into two groups to develop 1) a resolution designed to progress phase II of the mapping exercise and, 2) a new resolution addressing the role of nursing in relation to climate change/natural disasters. The resolutions are presented in full in Annex 4.

For Resolution 1 (education), it was moved by Mrs Kavaefiafi, Tonga and seconded by Mr Larui, Solomon Islands to accept the resolution. For Resolution 2 (pandemic and disaster preparedness), it was moved that the SPCNMOA Steering Group work on this further, with later distribution by email to the broader group for agreement. Ms Fritsch agreed to work further on the resolution on behalf of the steering group. The resolution was moved by Mrs Stowers, Samoa and seconded by Mrs Herman,Cook Islands to accept the resolution.

Session 10: Recap of SPCNMOA 2008 recommendations and resolutions - how well do they address the WHO Action Framework?Professor Debra Thoms, Chief Nursing & Midwifery Officer, NSW Health

Session 10 provided an opportunity to reflect on the meeting’s achievements (see Conclusions) and to raise any other issues.

It was agreed that the following individuals would form the Steering Committee for the next two years:


• Mrs Ana Kavaefiafi (CNO Tonga); • Ms Iokopeta Ngari (CNO Cook Islands); • Ms Leipakoa Matariki (CNO Vanuatu); • Mrs Mary Roroi (PNG – next SPCNMOA Chair);• Mrs Pele Stowers (CNO Samoa); and• Mrs Rusieli Taukei (CNO Fiji, current SPCNMOA Chair for next two years).

Having identified areas requiring further work on the previous day in relation to Objective 2.1 of the Strategic Action Plan for Nursing and Midwifery the next steps were discussed as follows:

Education – Resolution 1 was formulated, agreed and reflects the regional work needed in relation to education. It was agreed that the resolution would be circulated and the steering committee will look at who may be the most appropriate individuals to progress the work.

Leadership – It was agreed that a compendium of potential funding sources and awards needs to be compiled. During the meeting, strategies were shared about how to build leadership capacity and for delegates to work up a submission to support a program under leadership award programs.

Mrs Stowers said that when delegates return to their countries they should email their ideas to Ms Rumsey which could be included in an application to AusAID for an ALA Fellowship in August 2008.

Regulation – It was stated that there needs to be a mapping/review of frameworks across the region. ICN have developed a model act and training tool information and it may be worth working up a project to support the use of the ICN tool across the region. This would also be a capacity building exercise and would be particularly worthwhile for the smaller countries that do not have regulatory mechanisms. Mrs Herman said that because this is similar to the work of WPSEAR, SPCNMOA should link in with Karen Cook from the ANMC which also offers a mentoring program.

Data literacy – Skills in accessing, understanding and using data to support planning and decision-are required. It would be useful to explore whether the AusAID fellowship program would support upskilling in this regard. Mr Larui inquired as to whether the WHO CC NMHD could organise a regional research symposium on how countries can improve their use of data and how to translate recommendations into clinical practice.

It was agreed that these four areas will provide the basis for the work programme for SPCNMOA for the next 2 years.

It was also agreed that an Alliance email group will be established following the meeting.


Delegates were reminded to submit projects to the WHO Primary Health Care Awards.

The session concluded by Mrs Stowers challenging delegates to move things forward, not wait for others to do so.

Closing remarks

The next meeting will be held in Papua New Guinea in 2010 with the South Pacific Nurses Forum.

Mrs Taukei thanked the previous Chair Mrs Stowers, delegates, AusAID, WHO, FNMH UTS, WHO CC NMHD and UTS International.

Mrs Fritsch on behalf of the WHO thanked the Chair of the meeting and also the Secretariat for hosting the meeting. She stated that although there is a lot of work ahead, working together and collaboratively means that it can be done effectively.

Close of meeting

The meeting closed with a farewell song at 5pm.


3. Conclusions

The Meeting addressed issues relating to South Pacific nursing and midwifery leadership, human resources for health (HRH) and sustainable workforce issues, regional education and quality improvement frameworks; and disease prevention and management in core public health functions and risk management.

The role of the new WHO CC NMHD (FNMH, UTS) was outlined and capacity to assist with SPCNMOA activities was discussed. Delegates were made aware of funding opportunities and opportunities to submit ideas for proposals via the WHO CC.

The Constitution (see Annex 3) was refined and endorsed. Resolutions relating to education and disaster preparedness (Annex 4) were also endorsed.

Meeting achievements

• The successful launch of the WHO CC NMHD.• Ratification of the SPCNMOA constitution by meeting delegates.• Establishment of a Steering Committee. • Agreement that monetary contributions would be sought from member countries to enable

the SPCNMOA to work towards self-sufficiency and to fulfil its objectives. CNOs to discuss with their respective Ministries of Health the need for financial support for SPCNMOA activities.

• Review of WHO Strategic Action Plan for Nursing and Midwifery Development in the Pacific Island Countries. Members identified core areas of strategic action in relation to Objective 2.1 Research and policy analysis and resolved to work in collaboration with WHO on these areas. The areas requiring work were grouped under the headings of: education; leadership; regulatory frameworks and data literacy.

Education: A resolution Strengthening Nursing and Midwifery Education in the Pacific Island Nations (Resolution 1) was moved and seconded and encapsulates the work needed for Phase 2, building on the work of Phase I of the Mapping Exercise. In order to act on this resolution, it will be circulated to the steering committee. They will identify appropriate people to carry this work forward.

Leadership: A compendium of potential donor funding sources and awards will be compiled by the WHO CC.


Sharing of strategies for building leadership capacity emphasised the importance of CNOs understanding, implementing and influencing policy.

Members agreed to return to their countries and submit to the WHO CC their needs in respect of a leadership scheme within 6-8 weeks post-SPCNMOA meeting. The WHO CC undertook to develop a proposal for submission to the AusAID Leadership Awards (ALA).

Regulation: It was agreed that an analysis of regulatory frameworks across the region is needed. A project which will facilitate the use of the International Council for Nursing (ICN) tool (Model Act and Tool Kit) will help build capacity in the smaller Pacific countries that currently do not have regulatory mechanisms. In addition, the SPCNMOA will link with the Australian and Nursing Midwifery Council (ANMC) (the latter is the Secretariat to the Western Pacific and South East Asian Regulatory Meeting - WPSEAR) as the ANMC are in the process of discussions about a mentoring program.

Data literacy: The WHO CC NMHD will look at obtaining an AusAID fellowship to build capacity in the use and analysis of data to support decision-making and policy. The WHO CC NMHD was also requested to investigate opportunities for research focused on how countries can improve their use of HRH and other health planning data; how to translate recommendations and evidence into actions and practice. • In relation to pandemic and disaster preparedness there was a presentation, group discussion

and a resolution (resolution 2). The resolution relates to collaboration with partners to Strengthening nursing and midwifery capacity to reduce risks and deal with disasters and public health emergencies, including those related to climate change. The Steering Committee is to work on this further via teleconference and email.

• Networking amongst CNOs and educational representatives at SPCNMOA was enhanced by: building on and extending previous work relating to quality, educational frameworks and their linkage to regulation; joint commitment to new projects as outlined above; developing recommendations and agreement to set up an email list server.

• Identification of a SPCNMOA delegate to liaise with PHRHA. It was agreed that the focal person will rotate and will be the current SPCNMOA Chair.

• Members were requested to nominate any relevant projects which could be nominated for a WHO Primary Health Care Award.

• A report on the SPCNMOA 2008 meeting to be submitted to the South Pacific Nurses Forum.

• Ratification that the next SPCNMOA Meeting be held in PNG 2010.

The Constitution is found in Annex 3; the Resolutions in Annex 4.


Annex 1 List of meeting participants, speakers, facilitators

Chief Nurse representatives

Title

Mrs Fenuafala Faafoi Acting CNO, [email protected]

Ms Keti Fereti Principal Nursing Officer, Nieue Foou Hospital, Niue [email protected]

Mr Mark Jones CNO, New [email protected]

Mrs Ana Kavaefiafi CNO, [email protected]

Mr Michael Larui National Director of Nursing, Solomon [email protected]

Mrs Filoimanatu Leamea Acting Matron, [email protected]

Mrs Leipakoa Matariki Acting Matron, Princess Margaret Hospital, [email protected]

Ms Gano Mwareow DON, [email protected]

Ms Iokopeta Ngari Nurse Manager, Cook [email protected]

Mrs Tanimakin Nooti Ag Director of Nursing Services, [email protected]

Mrs Mary Roroi Principal Advisor Human Resources Training and Curriculum Development, Papua New [email protected]

Mrs Pelenate Stowers Assistant Chief Executive Officer, MoH, [email protected]

Mrs Rusieli Taukei Acting Director of Nursing and Health Systems Standards, [email protected]

Adj. Professor Debra Thoms CNMO, NSW [email protected]


Educational representatives

Mrs Fulisia Aiavao Dean, Faculty of Nursing, National University of [email protected]

Professor Denise Dignam Acting Dean, FNMH, UTS, [email protected]

Mrs Evelynne Emile Senior Clinical Tutor, Centre for Nursing Education, [email protected]

Mrs Verzilyn Isom Head of School of Nursing & Health Studies, College of Education, Solomon [email protected]

Mrs Filomena Mackay Acting Principal, Fiji School of Nursing, Tamarua, Suva, [email protected]

Mrs Nira Michael Principal, Lutheran School of Nursing, Papua New [email protected]

Mrs Rangi Tairi Principal Lecturer, Cook Islands School of [email protected]

Mrs Amelia Tu’ipulotu Acting Principal, Queen Salote Nursing School, [email protected]

Other

Mrs Neti Herman Observer, Cook [email protected]

Mrs Maatasesa Mathes Observer, [email protected]

Dr Mary McManus Senior Lecturer, School of Nursing, Auckland [email protected]

Mrs Toaga Seumalo President, American Pacific Nurse Leaders Council, American [email protected]

Professor Kim Usher Head, School of Nursing Sciences, James Cook University, [email protected]

Professor Jill White Dean, Faculty of Nursing, University of Sydney [email protected]

WHO

Mr Geoff Clark Technical Officer, Human Resources Development, WHO Papua New [email protected]

Ms Kathy Fritsch Regional Advisor in Nursing, WHO [email protected]

Ms Monica Fong Technical Officer, Human Resources and Health Systems Research, Office of WHO Representative in the South [email protected]


UTS

Professor Mary Chiarella FNMH

Ms Lisa Conlon [email protected]

Professor Caroline Homer [email protected]

Professor Lin Lock [email protected]

Elizabeth McInnes WHO CC [email protected]

Priya Nair [email protected]

Michele Rumsey WHO CC [email protected]

Invited but unable to attend

Dr Juliet Fleischl Technical Officer in Human Resources & Health Systems, WHO Representative Office, Fiji

Mrs Nira Michael Principal, Lutheran School of Nursing, Madang, Papua new Guinea

Dr Helen Tavola Social Policy Adviser, Pacific Islands Forum

Mr Stephan Terras Program management Officer, WHO Representative Office, Samoa

Ms Cathy Wasem Senior Public Health Advisor, Office of the Regional Health Administrator-HHS Region IX, Hawaii


Annex 2 MEETING AGENDA

WHO CC LAUNCH PROGRAM – Monday 7th April 2008

11.20am Welcome to UTS Professor Ross Milbourne, Vice-Chancellor and President, UTSProfessor Denise Dignam, Acting Dean, Nursing, Midwifery & Health, UTS

11.30am Why South Pacific Chief Nurses want a Collaborating Centre at UTS Mrs Pelenate Stowers, Chief Nursing Officer, Samoa & Ms Neti Herman, Former Chief Nursing Officer, Cook Islands

11.40am Reproductive health in the Pacific Associate Professor Rajat Gyaneshwar, Area Director of Women’s Health & Neonatology, Sydney South West Area Health Service and Foundation Member, Pacific Society for Reproductive Health

11.50am Implementing comprehensive HIV care in Papua New Guinea Mr Geoff Clark, WHO Papua New Guinea, Technical Officer - Human Resource Development

12.00pm Sustainable futures, healthy futures Professor Stuart White, Director, Institute for Sustainable Futures, UTS

12.10pm Introduction to the WHO CC NMHD - Terms of reference and work programme Professor Jill White, Dean, Faculty of Nursing & Midwifery, University of Sydney (member of WHO CC Advisory Panel)

12.20pm Ceremonial launch - Collaborating in the Western Pacific Ms Kathy Fritsch, WHO Regional Adviser, Nursing, Western Pacific Region OfficeProfessor Debra Thoms, Chief Nurse & Midwife, NSW Department of Health

12.30pm Closing remarks and congratulatory messages from international expertsMs Michele Rumsey, UTS: World Health Organisation Collaborating Centre for Nursing, Midwifery & Health Development

12.30pm Lunch provided

2.30pm Elluminate Live! Software training sessionUTS, Building 10, Level 3, Room 410

4.30pm Simulation demonstrationUTS, Building 10, Level 7, Laboratory 07.120


SPCNMOA Day 1 – Tuesday 8th April 2008

Morning Chair: Mrs Rusieli Taukei, Chief Nurse, Fiji

10.30am Welcome address and opening remarks SPCNMOA Chair, Mrs Rusieli Taukei, Chief Nurse, Fiji, Professor Denise Dignam, Acting Dean, Faculty of Nursing Midwifery & Health (FNMH), University of Technology Sydney (UTS)

10.45am Objectives & structure of Meeting – WHO Strategy and WHO Action FrameworkMs Kathy Fritsch, WHO Western Pacific Regional Office (WPRO) Nurse Adviser

11.00am Adoption of the 2006 Meeting report: resolutionsMrs Pelenate Stowers, Chief Nurse, Samoa and Mrs Rusieli Taukei, Chief Nurse, Fiji

1130am SPCNMOA constitutionMr Geoff Clark, Technical Officer, WHO PNG and Ms Michele Rumsey, WHO CC

12.00pm Lunch

Afternoon Chair: Ms Iokopeta Ngari, Nurse Manager, Cook Islands

1.00pm WHO Nursing/Midwifery Strategic Directions Consultation and Strengthening Nursing & Midwifery Education

Ms Kathy Fritsch, WHO Western Pacific Regional Office (WPRO) Nurse Adviser

2.00pm Pacific Human Resources Health AllianceMs Monica Fong, Technical Officer, Human Resources & Health Systems Research, WHO

2.30pm Country priority group discussions - Analysis of country templatesAssociate Professor Lin Lock, FNMH, UTS

3.00pm WHO Primary Health Care Compendium ProjectProfessor Mary Chiarella, FNMH, UTS

3.30pm Afternoon tea

4.00pm Drafting of SPCNMOA Action Plan & relationship to the WHO Action Framework & group discussionProfessor Debra Thoms, Chief Nursing & Midwifery Officer, NSW Health and Mr Michael Larui, Director of Nursing, Solomon Islands

5.00pm Feedback on discussions

5.30pm Close of Day 1


SPCNMOA Day 2 – Wednesday 9th April 2008

Morning Chair: Mrs Ana Kavaefiafi, Chief Nurse, Tonga

Financing and medical products/technologies 9.00am Strategies for realistic donor involvement

Ms Neti Herman, Cook Islands; Ms Michele Rumsey, WHO CC NMHD; Mrs Pele Stowers, Chief Nurse, Samoa

9.20am AusAID Leadership Capacity Fellowship Awards Associate Professor Lin Lock, FNMH, UT and Ms Michele Rumsey, WHO CC NMHD

9.40am Group discussion and feedback

10.30am Morningtea

Health workforce and information

11.00am Report on Enhancing and Standardising Regional Training Programmes in Nursing Mapping Exercise – prepared for Pacific Islands Forum Secretariat, SPCNMOA and WHO Ms Monica Fong, Technical Officer, Human Resources & Health Systems Research, WHO

11.20am Human Resources for Health – health system priorities Ms Michele Rumsey, WHO CC NMHD

11.40am Group discussion

12.00pm Lunch

Afternoon Chair: Mrs Filoimanatu Leauma, Acting Matron, Tuvalu

Service delivery and leadership/governance

1.00pm Asia-Pacific Emergency Disaster Nursing Network and Outcomes Ms Lisa Conlon, FNMH, UTS FNMH; Ms Keti Fereti, Principal Nursing Officer, Niue

1.30pm WHO Chief Nurse Leadership project Professor Jill White, Dean, Faculty of Nursing & Midwifery, University of Sydney

2.00pm Group discussion - SPCNMOA 2008 Meeting resolutions Mr Mark Jones, Chief Nurse, New Zealand and Ms Tanimakin Nooti, Acting Director of Nursing Services, Kiribati Suggested topics:World Health Day – Climate Change World Health Report 2006 – HRH World Health Report 2007 – Natural disasters World Health Report 2008 – Primary Health Care

3.00pm Afternoon tea

3.30pm Recap of SPCNMOA 2008 recommendations and resolutions - how well do they address the WHO Action Framework? Professor Debra Thoms, Chief Nursing & Midwifery Officer, NSW Health

4.30pm Arrangements for next meeting and 2008 meeting report availability

5.00pm Close of meeting


Annex 3

South Pacific Chief Nursing and Midwifery Officers Alliance: Constitution

1. Background and Rationale

The purpose of the South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA) is to enhance nursing and midwifery effectiveness in promoting and improving the population health in member jurisdictions. SPCNMOA intends to achieve its purpose by raising the quality and relevance of nursing, midwifery and health leadership in health services and nursing and midwifery education. This will be facilitated through forming alliances with, and collaborating closely with member jurisdictions, academic, regulatory and service partners in activities such as information sharing, capacity building, research, and education and service projects. These activities will be aimed at addressing national and sub-regional human resource and health service priorities. This purpose is integrally linked to those of the World Health Organization and other international, regional and national health agencies and ministries.

For the purpose of the Alliance, Chief Nursing and/or Midwifery Officers means a nurse and/or midwife appointed by the government of member countries to the role of providing official advice on nursing and/or midwifery and related issues. Where there is no national Chief Nurse and/or Midwife, then a nurse and/or midwife nominated by the Government of a member country, or where appropriate, a nurse and/or midwife nominated by a group of Chief Nurses will be deemed to be the Chief Nurse and/or Midwife. Member countries are Australia, the Cook Islands, Fiji, Kiribati, Nauru, Niue, New Zealand, Samoa, the Solomon Islands, Tokelau, Tonga, Tuvalu and Vanuatu, New Caledonia, French Polynesia, Wallis and Futuna, Papua New Guinea. The President of the American Pacific Nurse Leaders Council is also a member.

The key rationale for the alliance is to provide a forum for development support, networking opportunities for nurses and midwives working as leaders within governments of the South Pacific nations identified above. However, this constitution recognizes the essential contribution of nurse educators in developing, researching and evaluating policy and practice and provides for full membership to the alliance of representatives of any academic institution as so determined by the chief nursing and midwifery officers in membership of the alliance.

2. SPCNMOA Vision Effective partnerships and coordinated approaches for strengthening nursing and midwifery to improve Pacific health in an equitable and sustainable manner.


3. SPCNMOA MissionStrengthening nursing and midwifery capacity as a key priority for Pacific health systems development through country ownership and leadership.

4. ValuesThe SPCNMOA recognises these important values within its working relationships: • Collegial generosity;• Advocacy;• Reciprocity; and• Inclusiveness and partnerships.

5. SPCNMOA Objectives The objectives of SPCNMOA are to:a. Promote and maintain communication, networking mechanisms and mentoring for Chief

Nursing and/or Midwifery Officers;b. Discuss matters confronting nurses, midwives and health systems in member jurisdictions and

to examine solutions and resolutions to identified issues and challenges;c. Expand knowledge, improve management, leadership and evaluation skills, and undertake

capacity building projects to facilitate effective leadership and management of identified issues and problems affecting nursing, midwifery, human resources for health and health systems;

d. Initiate, participate in and provide support for research and development at regional, sub-regional, national and international levels on issues of importance to nursing, midwifery, human resources for health and health systems;

e. Develop and implement regional, sub-regional and national strategic plans for issues of importance to nursing, midwifery, human resources for health and health systems;

f. Improve the quality and relevance of nursing and midwifery education through planning and implementing innovative curricula, education and training programmes and workshops, and the development of educational standards; and

g. Engage and communicate with key stakeholders in line with the objectives of the alliance.

6. SPCNMOA Working Principles The SPCNMOA and any projects that it initiates or facilitates are supportive of member countries’ to self-determine their own priorities. The work of the SPCNMOA is guided by the following principles:• Inclusiveness and partnerships: the SPCNMOA is actively seeking the involvement and

contribution of all stakeholders that wish to contribute to the aims and activities of the Alliance.

• Realistic: its structure and processes should be straightforward and practical and its work plans realistic with achievable goals and outcomes.

• Adaptability and Flexibility: it operates in a way that is flexible, adaptable and responsive to the needs of member countries.


• Sustainability and Mutual support – it acknowledges the contributions and support from development partners, technical and donor agencies in addressing nursing and midwifery issues in the Pacific and the expected need for continued support in future.

7. SPCNMOA membership

7.1 The SPCNMOA will have two categories of membership:(a) Regular Membership; and(b) Co-opted Membership

7.2 A Regular Member means a Chief Nurse and/or Midwife from the South Pacific Nations and representatives of education institutions as agreed by the chief nurse/midwife members.

7.3 A Co-opted Member means a representative of any organization which regular members of the Alliance feel will contribute to the objectives of the Alliance.

8. Alliance steering committeeThe steering committee will be composed of five members drawn from the Alliance’s regular membership, including the current and designated chairpersons. Additional members of the steering committee will include the secretariat and the World Health Organization. The steering committee will meet twice yearly by any means and any other time as determined by the chairperson, in consultation with the secretariat.

9. SPCNMOA Secretariat

9.1 The WHO Collaborating Centre for Nursing, Midwifery and Health Development at the University of Technology Sydney, Faculty of Nursing, Midwifery and Health, as Secretariat, is the administrative component of the SPCNMOA responsible for facilitating and providing support to member countries and for coordinating efforts to address issues raised by the members of the Alliance.

9.2 The Secretariat will work with the steering committee and report to the members of the SPCNMOA on an agreed format and timeframe as required and/or specified in the SPCNMOA Work Plan. The Secretariat will be responsible for ensuring that all correspondences and reporting is undertaken as per members request. As such, the Secretariat will also act as the conduit for information flow to and from the SPCNMOA.

9.3 The Secretariat in collaboration with the steering committee will ensure the production and dissemination of meeting reports, as well as monitoring and evaluation of the SPCNMOA’s action plan.


10. Decision Making

10.1 Any matters for consideration by the Alliance will be determined by consensus of the Regular Members. Where this is not possible, then decisions will be by simple majority in a vote. Where there are an equal number of votes, the Chairperson shall have the casting vote.

10.2 A matter of procedure at a meeting of the Alliance is to be determined, in so far as it is consistent with these Terms of Reference, in accordance with NE Renton’s “Guide for Meetings”.

11. Funding support and management of funds

11.1 It is also envisioned that funding support for the Alliance and its work plan will be sought from development partners who may or may not be members of the Alliance. The eventual aim of the Alliance is to achieve a position of self-sustainability.

11.2 Co-opted Members from time to time shall contribute an amount, as determined from time to time by the Alliance, as biennial dues. However, as approved by the Alliance, Co-opted Members may provide in-kind contributions in lieu of biennial dues.


Annex 4

SPCNMOA 2008 RESOLUTIONS

RESOLUTION 1 - STRENGTHENING NURSING AND MIDWIFERY EDUCATION IN THE PACIFIC ISLAND NATIONS

Preamble

The South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA), representing the nursing and midwifery leaders working in Governments across the South Pacific in 14 Pacific Island Nations.

Recognizing the need to formally collaborate in exploring innovative cross-border structures and processes to closely align efforts, expertise and resources to strengthen nursing and midwifery institutional and faculty capacities, curricula, clinical education capacities, quality frameworks and resources to produce, retain and support a competent, effective, responsive and equitably distributed nursing and midwifery workforce providing universal access to quality health services across the continuum of care.

Taking note of the conclusions and recommendations contained in the report of the Pacific Islands Forum Secretariat of the mapping of educational and regulatory situations and needs in the Pacific Island Nations, which include a call for intensified and concerted efforts to strengthen education institutions in a more effective manner, addressing faculty development needs; curricular strengthening focused on core, essential competencies, overall academic quality standards and course/programme recognition and/or accreditation.

Affirming and fully supporting the human resources for health (HRH) comprehensive strategic plans described in the World Health Report 2006; the WHO Western Pacific Regional Strategy on Human Resources for Health (2006-2015); its’ framework for strengthening health systems: Everybody’s Business: Strengthening Health Systems to Improve Health Outcomes; The Pacific Plan (2005); and the Strategic Action Plan for Nursing/Midwifery Development in the Western Pacific Region.

Declare that SPCNMOA members, including academic and training institutions, WHO Collaborating Centres, regulatory representatives, development partners, international agencies and other relevant networks, including but not limited to Councils of Deans and the American Pacific Nurse Leaders Council (APNLC) can significantly strengthen nursing and midwifery educational capacities, quality, effectiveness and research through collaborative and coordinated efforts and partnerships.


SPCNMOA recommends that:

1. A formal infrastructure and knowledge, resource-sharing network of educational institutions, chief nursing/midwifery officers, educators and regulatory representatives be formed to support: • The sharing of educational resources; • Enhanced instructional, clinical education, programme planning and evaluation skills of

current nursing and midwifery faculty; • Development of new faculty and instructors who are not only prepared academically,

but are also competent clinical and theoretical teachers; and • Evidence-based guidelines, structures and processes to facilitate regional curricular

standardization, systems of academic quality improvement and accreditation in the field of nursing and midwifery education; mechanisms supporting course and programme cross-institutional and cross-border recognition as well as competency-validation measures.

2. The network and partners collaborate to develop, implement, monitor and evaluate nursing/midwifery education demonstration projects designed to:• Establish and strengthen the working relationships among institutions; • Implement and test the latest communication technologies, • Foster strategies for resource sharing, • Implement institutional and faculty capacity-building initiatives in priority education and

service delivery areas; and • Analyze various options and pilot-test a curricular standard-setting process and academic

quality improvement framework designed to facilitate curricular standardization focused on core competencies, continuous academic quality improvement frameworks and supportive processes; and mechanisms supportive of cross-border professional registration and competency-validation.

3. A taskforce be created by the SPCNMOA, its’ steering committee, secretariat and WHO to support the implementation of activities to support this resolution.

4. SPCNMOA is represented by its chairperson on the Pacific Human Resources for Health Alliance (PHRHA), with the provision of funding to meet the costs of that participation.

5. SPCNMOA in collaboration with development partners will seek sufficient funds and resources for successful implementation and evaluation of the resolution actions.


RESOLUTION 2 - STRENGTHENING NURSING AND MIDWIFERY CAPACITY TO REDUCE RISKS AND DEAL WITH DISASTERS AND PUBLIC HEALTH EMERGENCIES, INCLUDING THOSE RELATED TO CLIMATE CHANGE

Preamble

The South Pacific Chief Nursing and Midwifery Officers Alliance (SPCNMOA), representing the nursing and midwifery leaders working in Governments across the South Pacific in 14 Pacific Island Nations:

Alarmed by the mounting negative effects of climate change on the health and development of Pacific Island nations and territories and their vulnerability to the effects of drought, floods, earthquakes, other national disasters and climate-sensitive diseases

Acknowledging the sluggish pace of learning from disasters and insufficient investments in setting policies and taking action to reduce the suffering, burden of disease, death and economic costs of disasters and public health emergencies

Affirming and fully supporting the various international, United Nations and Regional resolutions on disaster mitigation and climate change and health

Declare that: SPCNMOA members, including academic and training institutions, WHO Collaborating Centres, partners, international agencies and other relevant nursing and health professional networks and partners, including but not limited to the American Pacific Nurse Leaders Council (APNLC), the Asia Pacific Emergency and Disaster Nursing Network, the Red Cross, can work together in building partnerships. These partnerships can inform and influence policies and actions, including the strengthening of capacities to assess disaster and climate change vulnerabilities, reduce risks and deal with disasters and other public health emergencies.

SPCNMOA Commits to: 1. Actively participate in the development, implementation and evaluation of an emergency and

disaster ‘train the trainers’ course to ensure relevance of the programme in response to the member countries individual needs.

2. Work collaboratively with all stakeholders, including development partners, to educate and prepare nurses and midwives to deliver high quality care to emergency and disaster affected populations.

3. Advocate for member governments to consider and prepare to deal with issues concerning environmental, in particular, climate changes, and the subsequent effects of this on preparing for and responding to emergency and disaster situations.


Ann

ex 5

Act

ion

plan

res

ulti

ng fr

om S

PCN

MO

A m

eeti

ng 2

008

ARE

A O

F W

ORK

AC

TIVI

TYRE

SPO

NSI

BILI

TYTI

MEL

INE

Gen

eral

Mon

etar

y co

ntrib

utio

ns

for S

PCN

MO

A w

ork

To a

ppro

ach

in-c

ount

ry M

inist

ries

of H

ealth

for fi

nanc

ial s

uppo

rtCo

untry

CN

Os

Oct

ober

200

8

Prim

ary

Heal

th C

are

Awar

dTo

sub

mit

awar

d en

tries

and

sug

gest

eve

nts

whe

re th

e Aw

ard

can

be p

rom

oted

SP

CNM

OA

dele

gate

s

WHO

CC

FNM

H, U

TS w

ill n

otify

SP

CNM

OA

whe

n no

min

atio

ns a

re d

ue

Year

ly

Pacifi

c Hu

man

Res

ourc

es

for H

ealth

Alli

ance

To li

aise

with

PHR

HA a

nd e

stab

lish

and

stre

ngth

en w

orki

ng

rela

tions

hips

via

SPC

NM

OA

Chai

r as

repr

esen

tativ

e of

Sou

th P

acifi

c go

vern

men

t nur

sing

& m

idw

ifery

lead

ers

To e

xplo

re p

rovi

sion

of fu

ndin

g to

mee

t cos

ts o

f par

ticip

atio

n

SPCN

MO

A Ch

air (

repr

esen

tativ

e on

PH

RHA)

WHO

CC F

NM

H UT

S to

liai

se w

ith

dono

rs a

nd re

gion

al o

ffice

As re

quire

d

Com

mun

icatio

n be

twee

n SP

CNM

OA

dele

gate

sTo

est

ablis

h a

list s

erve

r for

the

purp

ose

of in

itiat

ing

disc

ussio

ns

and

shar

ing

info

rmat

ion

and

reso

urce

s re

latin

g to

the

wor

k of

SP

CNM

OA

E-ne

wsle

tter (

eg.,

sum

mar

y of

WHO

and

oth

er m

eetin

gs, e

vent

s an

d po

licie

s)

Dele

gate

s to

forw

ard

mat

eria

l for

inclu

sion

in n

ewsle

tter

Stee

ring

com

mitt

ee m

eetin

g at

leas

t tw

ice a

yea

r and

as

requ

ired

WHO

CC

FNM

H UT

S

All

Stee

ring

com

mitt

ee

Ong

oing

Nxt

mtg

: Nov

20

08


WH

O S

trat

egic

Act

ion

Plan

for

Nur

sing

and

Mid

wife

ry D

evel

opm

ent

Educ

atio

n(R

esol

utio

n 1)

To id

entif

y ap

prop

riate

peo

ple

to c

arry

forw

ard

the

wor

k of

pha

se 2

of

the

Map

ping

Exe

rcise

To e

stab

lish

a fo

rmal

net

wor

k of

edu

catio

nal i

nstit

utio

ns, C

NM

Os

and

regu

lato

ry re

pres

enta

tives

to s

uppo

rt a

num

ber o

f rel

ated

ac

tiviti

es

For t

he n

etw

ork

and

partn

ers

to d

evel

op, i

mpl

emen

t, m

onito

r and

ev

alua

te e

duca

tiona

l dem

onst

ratio

n pr

ojec

ts

A ta

skfo

rce

be c

reat

ed b

y th

e SP

CNM

OA,

its’

ste

erin

g co

mm

ittee

, se

cret

aria

t and

WHO

to s

uppo

rt th

e im

plem

enta

tion

of a

ctiv

ities

to

supp

ort t

his

reso

lutio

n.

To s

eek

fund

s an

d re

sour

ces

for i

mpl

emen

tatio

n an

d ev

alua

tion

of

reso

lutio

n ac

tions

, inc

ludi

ng fu

ndin

g to

mee

t cos

ts o

f par

ticip

atio

n of

SPC

NM

OA

Chai

r in

PHRH

A

Stee

ring

Com

mitt

ee/E

duca

tiona

l Ta

skfo

rce

whe

n fo

rmed

Thos

e in

tere

sted

to c

onta

ct W

HOCC

, FN

MH

UTS

Stee

ring

Com

mitt

ee in

col

labo

ratio

n w

ith d

evel

opm

ent p

artn

ers

and

task

forc

e

Aug

7th,

200

8

Lead

ersh

ipTo

com

pile

a c

ompe

ndiu

m o

f pot

entia

l fun

ding

sou

rces

To s

ubm

it to

WHO

CC

NM

HD a

reas

of n

eed

in re

spec

t of a

le

ader

ship

pro

gram

To s

ubm

it pr

opos

al fo

r sub

miss

ion

to A

usAI

D AL

A Fe

llow

ship

WHO

CC F

NM

H, U

TS

SPCN

MO

A de

lega

tes

WHO

CC F

NM

H, U

TS

Sept

embe

r 200

8

End

July

2008

Augu

st 2

008

Regu

latio

nAt

a la

ter d

ate

to s

et u

p ta

skfo

rce

to e

xplo

re p

ossib

le w

ork

rela

ting

to re

gion

al re

gula

tory

fram

ewor

ks a

nd u

se o

f the

ICN

tool

Mod

el

Act &

Tool

Kit

and

linki

ng w

ith A

NM

C m

ento

ring

prog

ram

me.

To

expl

ore

fund

ing

sour

ces

to c

arry

out

any

wor

k in

this

resp

ect.

Stee

ring

com

mitt

eeTB

C


Data

lite

racy

To s

eek

AusA

ID A

LA F

ello

wsh

ip fu

ndin

g to

bui

ld c

apac

ity in

the

use

and

anal

ysis

of d

ata

to s

uppo

rt de

cisio

n-m

akin

g an

d po

licy

Inve

stig

ate

oppo

rtuni

ties

for r

esea

rch

on: a

) ho

w c

ount

ries

can

impr

ove

thei

r use

of H

RH a

nd o

ther

hea

lth p

lann

ing

data

; and

b)

how

to tr

ansla

te re

com

men

datio

n an

d ev

iden

ce in

to a

ctio

ns a

nd

prac

tice

a) S

PCN

MO

A de

lega

tes

to s

ubm

it to

W

HO C

C FN

MH,

UTS

rele

vant

idea

s

b) W

HOCC

FN

MH,

UTS

to p

repa

re

appl

icatio

n fo

r sub

miss

ion

a) C

ount

ries

to li

nk in

to H

RH-IM

S w

ork

bein

g un

derta

ken

by W

HO C

C FN

MH,

UT

S

b) N

eeds

rela

ting

to th

is w

ill b

e in

corp

orat

ed in

to A

LA a

pplic

atio

n as

ap

prop

riate

. Cou

ntrie

s to

sub

mit

to

WHO

CC

FNM

H, U

TS in

form

atio

n on

sp

ecifi

c ne

eds

rela

ting

to th

is ac

tivity

c) S

pecifi

c re

sear

ch p

ropo

sals

to

be in

vest

igat

ed a

t a la

ter d

ate

by

SPCN

MO

A

End

July

2008

Augu

st 2

008

Ong

oing

End

July

2008

TBC

HRH

MDS

To c

ontin

ue to

sha

re in

form

atio

n an

d w

ork

rela

ting

to H

RH

All

Ong

oing

Glo

bal R

egio

nal N

etw

orks

To li

nk in

to th

ese

– w

ork

prog

ram

/sta

ndar

ds

Circ

ulat

ion

of W

HO d

ocum

ent:

Scal

ing

up N

ursin

g an

d M

idw

ifery

Ca

pacit

y to

Con

tribu

te to

MDG

s

All

WHO

FN

MH

UTS

TBC

July

2008


Pand

emic

and

dis

aste

r pr

epar

edne

ss

Reso

lutio

n 2

As p

er re

solu

tion

To c

ircul

ate

to re

leva

nt o

rgan

isatio

ns in

ord

er to

pub

licise

SP

CNM

OA’

s po

sitio

n. S

PCN

MO

A de

lega

tes

to n

omin

ate

appr

opria

te o

rgan

isatio

ns a

nd s

ubm

it to

WHO

CC

FNM

H UT

S

Furth

er d

iscus

sion

at S

hand

ong

mee

ting

Stee

ring

Com

mitt

ee

All

Atte

ndee

s

ASAP

16-2

0th

Oct

200

8

report on the south pacific chief (spcnmoa) meeting on the south pacific chief nursing and midwifery...

Documents