Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

Abstract

Objective:to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method:we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results:given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions:given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries.

Estratégia de implementação para a prática avançada de enfermagem na Atenção Primária à Saúde no Chile

“…(5,6) Further analysis of APN outcomes demonstrates their alignment with policy priorties in Latin American and Caribbean (LAC) countries to achieve universal health and universal health coverage. (7) Unlike some countries, where nursing has developed over 50 years to educate APNs, expand their scope of practice, and demonstrate the quality of their practice, in LAC countries the APN is a new concept.…”

The daily routine of nurses in rural areas in the Family Health Strategy

“…Internationally, remote and rural areas are the places where there is greater difficulty in covering health services, with poorer health outcomes, especially related to maternal and infant mortality, infectious diseases, and aging (2) . Other difficulties are also observed, such as maintenance of health professionals in these areas, unequal distribution and high turnover of these workers, especially physicians (3) .…”

Prática avançada de enfermagem na América Latina e Caribe: análise de contexto

“…(4) Th e inclusion of APN showed nurses' relevance by demonstrating that their autonomy promoted greater coverage of care, more effi cient care, reduction of costs, eff ective management activities in line with population demand, credibility and affi rmation of the profession. (3,5) With a view to providing greater accessibility and quality of care, APN was disseminated worldwide, in Canada in the late 1960s, and in Europe and Asia in the 1980s. (1,2,5) In Latin America, APN spread only at the beginning of the 21 st century through the formulation of resolutions and research developed in educational institutions.…”