Nurses make up half of the world’s healthcare workforce, yet are vastly underrepresented in healthcare leadership. Moreover, women make up 90% of all nurses, yet only occupy 25% of health leadership positions. Nurses face complex role and gender-related barriers as they advance in their careers. For decades, global health authorities including WHO and International Council of Nursing have been calling for nurses to be leaders at all levels of the health system. However, this has not resulted in major shifts in educational curricula, investment in training, or an increase in the proportion of nurses serving as leaders of health systems.

The lack of an agreed upon competency framework makes it difficult for nurses to know what they need in terms of knowledge, skills and abilities for leadership at each stage of their careers, and for institutions to identify which competencies their education and development programs should provide. Additionally, considering that the majority of nurses are women, there is a need to specifically support the development of leadership capacities in women to help mitigate cultural, organizational and contextual barriers, and to advocate for models of inclusive leadership and governance that challenge traditional social and gender hierarchies.

The Center is supporting the development and validation of a global nursing leadership competency framework that can be implemented nationally and locally as part of creating a thriving health workforce, strengthening health systems, and closing health worker coverage gaps. The framework covers pre-service learning, continuing professional development, performance appraisals and professional development pathways. The goal is to lay the groundwork for nurses in both high and low-resource settings and those from student to entry-level to Chief Nursing Officer to understand and exhibit appropriate leadership competencies, and for pre-service and in-service education programs to have a benchmark against which to standardize their curricula.

Additionally, the Center is working to build respect, recognition and support for the nursing profession by strengthening national nursing associations who provide protection, support and advocacy for nurses on the ground. To that end, with funding from Johnson & Johnson Foundation, we partnered with ICN to create ODENNA to build stronger and more sustainable nursing associations, initially in Africa, so that nurses can be valued as knowledgeable professionals and system navigators and to enable nurses to effectively influence and positively impact improvements in healthcare delivery.