International Perspectives

ICN launches new phase of TB/MDR project

The International Council of Nurses (ICN) is transforming the care, prevention and management of tuberculosis and drug-resistant TB through an innovative project. Now in its third phase, the project is based on a new training methodology that promotes peer education, utilizes a practical, problem-solving approach, and takes into account nurses' working environments.

The third phase of the ICN TB/MDR-TB Project is funded by a United Way Worldwide grant made possible by the Lilly Foundation on behalf of the Lilly MDR-TB Partnership. Since 2005 ICN, funded by Lilly, has worked with its member national nurses associations (NNAs) and other partners to develop nursing capacity in TB and MDR-TB in countries where TB represents a high burden of disease.

Tuberculosis (TB) is a preventable disease that kills 1.7 million people every year. Each year nearly a half million people worldwide are infected by drug-resistant TB (MDR-TB), which is difficult to treat and represents a growing threat to global public health. Improving the quality of patient care will help to reduce the impact of TB and the emergence of drug-resistance.

‘Our goal is to improve practice and, as a result, patient outcomes. The ICN capacity-building project relies on expert nurses working with front-line health professionals to improve their knowledge and their ability to provide training and leadership to their colleagues’, stated Gini Williams, ICN TB Project Director.

To date more than 1400 nurses in countries with a high burden of TB and MDR-TB have participated in ICN training for trainers (TOT) courses. These nurses have, in turn, been involved in training 60 000 additional nurses and allied health workers in 16 countries with a high burden of TB and MDR-TB.

‘In Phase 3, we will strengthen our research capacity’, Williams said. ‘Because so many nurses and other health care providers have been involved in our project, we have gathered a wealth of information regarding the day-to-day challenges of delivering quality care and the barriers that affect access to treatment. This information creates a detailed picture of how care is delivered to people affected by TB in the countries where we are active. We plan to publish solid evidence with regard to the impact of our training, mentorship and advocacy efforts at a ground level. This will allow us to advocate for a model which has already shown exciting results’.

Research networks have been established in China and Russia. The first research training workshop will take place in Russia in February.

China, India, Russia and South Africa are a special focus of the project's third phase. In addition ICN will work in collaboration with ICN Wellness Centres for Health Care Workers® to strengthen the TB project in Ethiopia, Lesotho, Malawi, Swaziland, Uganda and Zambia. The Wellness Centres support the development and delivery of health care services for health care workers and their families in countries where rates of TB and HIV are a serious problem. Like the TB Project, the Wellness Centres operate through the ICN member NNA in each country.

Also active in Indonesia and the Philippines, the ultimate goal of the ICN TB project is to achieve better outcomes for patients, safer working environments for nurses and other health care workers, and to reduce TB and MDR-TB transmission, morbidity and mortality.

In addition to the in-person TOT activities, ICN has developed an interactive E-learning course which is available on-line and on CD-rom. The course provides instruction on all aspects of the care, prevention and management of TB and MDR-TB. The course can be accessed at

The Lilly MDR-TB Partnership is an international alliance of public and private organizations, including businesses, humanitarian organizations, academic institutions, and health care professional associations. The partnership pursues a multi-pronged strategy to train front-line health care personnel; to increase the supply and availability of effective drugs; and to focus global resources on prevention, diagnosis, care and treatment of MDR-TB.

Nurses welcome gift of ICN/MSD Mobile Library

Nurses in Monrovia, Liberia welcomed the arrival of an ICN/MSD Nursing Mobile Library given in memory of an American woman who prior to her death at age 21 was involved in many philanthropic organisations. The mobile library provides up-to-date nursing and health information to nurses as they deliver vital services in the most difficult of situations.


Nurses in Monrovia, Liberia welcome the arrival of an ICN/MSD Nursing Mobile Library given by the Emily C. Specchio Foundation in memory of a young American woman. The mobile library provides up-to-date nursing and health information to nurses working in developing countries and/or remote areas.

The Emily C. Specchio Foundation sponsored the mobile library. A not-for-profit organisation, the foundation encourages, identifies and financially supports youth who pursue study and/or programmes underlying the values of social justice both nationally and internationally. The mobile library was delivered to Monrovia on the sixth anniversary of Emily's death.

With the support of The Merck Company Foundation and Elsevier, ICN initiated the innovative ICN/MSD Nursing Mobile Library project in 2001 to deliver essential knowledge to nurses working in developing countries and/or remote areas. Each library contains approximately 90 nursing and health publications, including books, manuals and fact sheets, organised in a sturdy trunk resistant to moisture and insects. To date, more than 329 mobile libraries in English, French or Portuguese have been delivered to nurses working in 29 countries on the African continent and Haiti.

Individuals, groups and organisations can help nurses improve health care for burdened and vulnerable populations by sponsoring one or more ICN/MSD Nursing Mobile Libraries. The name of the sponsor will be printed on the trunk which houses the library. Anyone interested in sponsoring a mobile library may contact Nadia DeCarlo at More information about the mobile libraries is available at and

ICN offers guidance on adult and childhood immunisation

A newly updated monograph on adult and childhood immunisation provides up-to-date information to nurses and other health professionals. The International Council of Nurses (ICN) offers the publication free of charge at:

Immunisation is a successful and cost-effective public health intervention, a key strategy to ensure global health security, and a response to the threat of emerging infections. Immunisation is critical to the achievement of Millennium Development Goal 4: to reduce mortality in children under age five by two-thirds by 2015. Modern vaccines have saved the lives of millions by controlling many severe childhood diseases and eradicating others, such as smallpox.

Nurses have possibly the most important role to play of any health care professional in the immunisation process. As the largest professional group present in all health settings, nurses are most likely to advise and inform parents on vaccination, as well as actually administer vaccines. They are also well placed to act as role models to achieve national goals and targets for immunisation coverage.

The monograph presents information regarding:

  • how vaccines work, and the value, safety and cost-effectiveness of immunisation throughout life
  • role of nurses in immunisation
  • under use of vaccines
  • development of new vaccines
  • how to minimise and report adverse events following immunisation
  • safe immunisation practices.

ICN also has updated its fact sheets on the immunisation of health workers, influenza, pneumococcal pneumonia, herpes zoster (shingles), and the human papilloma virus (HPV). Fact sheets are available free of charge on the ICN website:

Health care equity, access theme of 2013 ICN Congress in Melbourne, Australia

Thousands of nurses and others in the field of health will gather to exchange scientific information, share ideas and network at the 25th Quadrennial Congress of the International Council of Nurses (ICN). Focused on the theme of Equity and Access to Health Care, the Congress will take place from 18–23 May 2013 at the Melbourne Convention and Exhibition Centre in Melbourne, Australia.


Professor Sheila Tlou, Director, UNAIDS Regional Support Team for Eastern and Southern Africa.


Anne Marie Rafferty, Dean, Florence Nightingale School of Nursing and Midwifery, King's College, London.

The Congress, organized with the support of the Australian College of Nursing, is a global platform for the dissemination of nursing knowledge and leadership across specialities, cultures and countries. Participants will have a unique opportunity to meet and interact with clinicians, leaders and decision-makers in nursing and health care internationally.

Nearly 3000 abstracts were submitted from 75 countries, representing an increase of 40 percent from the ICN Conference held in 2011. The four-day scientific programme will offer four plenary sessions, including a debate, and 18 main sessions with more than 50 international speakers. Dr Richard Visser, Minister of Health Welfare and Sport for Aruba will deliver a plenary presentation on the subject of obesity. Professor Sheila Tlou, Director, UNAIDS Regional Support Team for Eastern and Southern Africa, will speak on the Millennium Development Goals (MDGs).

Anne Marie Rafferty, Dean of the Florence Nightingale School of Nursing and Midwifery at King's College London, will present the Virginia Henderson Memorial Lecture, which honours Virginia Henderson, an American nurse who made an extraordinary contribution to nursing and health. The Florence Nightingale International Foundation's Fundraising Luncheon raises funds for the Girl Child Education Fund (GCEF) established to support the education of girls in sub-Saharan Africa. Tickets for the luncheon, to take place 21 May 2013, may be purchased while registering for the Congress (

More information about projects supported by the FNIF can be accessed at


The Congress will feature a Student Nurses Assembly, and all ICN Networks will meet. Prior to the Congress, the Council of National Representatives (CNR), ICN's governing body, will convene in Melbourne from 16–19 May 2013. Congress participants who are members of ICN member associations will be able to observe global nursing leaders identify the profession's priorities and future directions. The election of ICN's president and new Board members will take place during the CNR.

The ICN Congress website ( offers the latest information about speakers, the scientific programme and related events and activities.

Members of nursing associations, other health professionals, and members of the public may register online at the website. Participants may also register online for special events and professional visits to learn about nursing practice and health care in Australia.

ICN convenes experts on nursing registration and licensure


In late 2012 experts on nursing regulation gathered in Geneva for the seventh annual meeting of the ICN Observatory on Licensure and Registration. Attending were (from left to right): First row seated: David Benton, ICN CEO; Rosemary Bryant, ICN President; Jean Barry, Consultant, Nursing and Health Policy, ICN; and Maricel Manfredi, formerly a Human Resources Consultant in Nursing, Pan American Health Organization/WHO. Second row: Chris Robertson, Observer, Director, National Board Services, Australian Health Practitioner Regulation Agency; Kathy Apple, Executive Director National Council of State Boards of Nursing, USA; Dileep Kumar, President, Indian Nursing Council, India; Veronica Darko, Registrar/Chief Executive Officer, Nurses and Midwives Council of Ghana; Anne Carrigy, President, Nursing and Midwifery Board of Ireland; and Pauline Tan, Chief Nursing Officer, Singapore Nursing Board. Third row: Richard Barnes, Public Expert on Regulation, Australia; Abdullah al Nuimi, Section Head of Regulation and Registration, Department of Nursing, Ministry of Health, United Arab Emirates; Carolyn Reed, CEO/ Registrar Nursing Council of New Zealand; Hussain Jafri, International Alliance of Patients' Organizations United Kingdom. Photo credit: Lorenzo Chiriatti, ICN.

Experts on nursing regulation from six continents gathered in Geneva for the seventh annual meeting of the ICN Observatory on Licensure and Registration. Through the ten-member Observatory, the International Council of Nurses (ICN) and the nursing profession anticipate and respond to international regulatory developments, and influence policy on global regulatory matters.

Participating were experts from Europe, Africa, Asia, South Pacific, North America and Latin America, as well as two public representatives, one person with legal expertise and a global leader in patient advocacy. Rosemary Bryant, ICN President, chaired the two-day meeting, which took place in Geneva in late 2012.

‘With regulation as one of its three pillars, ICN values the input and expertise of Observatory members and their significant contribution to the work of ICN,’ stated David Benton, ICN CEO.

Members of the Observatory presented information on regulatory trends and issues in their regions. They also provided input on several ICN projects including an update of Nursing Care Continuum: Framework and Competencies; a new toolkit on regulatory governance; and numerous position statements.

A report on on-going regulatory research into existing and emerging regulatory models including features of a high performing regulatory body was presented. Participants also discussed the concepts of leadership versus management, as well as the state of nursing research in the area of regulation.

Nurses address workplace issues at ICN Asia Forum

Presidents and nurse leaders from national nursing associations (NNAs) across Asia gathered in Bangkok for the 13th International Council of Nurses (ICN) Asia Workforce Forum. The forum consists of a well-established network of NNA representatives interested in work-life issues affecting nurses.

The Nurses Association of Thailand hosted the forum and co-chaired the two-day meeting in partnership with ICN. NNA Presidents and nurse leaders from Hong Kong, Indonesia, Japan, Korea, Macau, Malaysia, Philippines, Singapore, Taiwan and Thailand participated.

Held in November, the forum provided a platform for nurse leaders to share ideas and experiences related to socio-economic welfare nursing issues in the region. Strategic discussions focused on how to address today's challenges as well as those of the future. Each country presented a comprehensive national report. ICN presented data from two surveys: Nurses' Wages and their Context, and Nursing Workforce Profile.

David Benton, ICN Chief Executive Officer, who participated in the forum, was dismayed to learn of the lack of permanent posts for nurses in Thailand's civil service. ‘This places patient care at risk’, he stated. ‘Enthusiastic, newly qualified nurses are looking for opportunities to consolidate their practice and contribute to improving the health and wellbeing of Thai citizens. Temporary, short-term posts do not facilitate this and also are inefficient. If jobs are not available, nurses look to other countries for work, and fewer people choose nursing as a career’.

The program included a training session on the subject of enhancing image through the media, led by Dr Sakda Pannengpetch of Chulalongorn University. Participants also conducted an environmental scan, and discussed strengthening positive practice environments, ageing, development of a disaster nursing workforce, chronic diseases, and shift work.

The next ICN Asia Workforce Forum, to be co-hosted by the Philippines National Nursing Association, will take place in Manila November 2013.

GCEF coordinators share skills, solve problems at strategy workshop


The coordinators of the Girl Child Education Fund participated in the eighth annual GCEF Coordinators Workshop at the ICN offices in late 2012. Shown from left to right are: Faith Mbehero, Kenya; Tiny D'lamini, Swaziland; Amandi Simon Ongua, Uganda; and Jennifer Munsaka, Zambia. Photo credit: ICN.

The coordinators of the Girl Child Education Fund (GCEF) in Kenya, Swaziland, Uganda and Zambia participated in a skill building and strategic planning workshop at the International Council of Nurses (ICN) office in Geneva in late 2012. The workshop was supported by an educational grant from Pfizer External Medical Affairs.

‘The coordinators have developed an innovative platform of professional skill sharing, strategic planning, problem solving and friendship, which is highly effective in supporting the GCEF and helping it evolve’, said Rosemary Bryant, ICN President. ‘Without their dedication and constant efforts to improve the lives and futures of the girls who benefit from the GCEF, this programme would be simply impossible. Many orphaned daughters of nurses would be denied the opportunity for education and a brighter future’.

Through the GCEF, nurses and their associations around the world, individually and collectively, support the primary and secondary schooling of girls whose nurse parent or parents have died. Launched in 2006, it is an initiative of the ICN and its sister organisation, the Florence Nightingale International Foundation (FNIF).

Workshop results included:

  • creation of a step-by-step plan for the development of country-based and international networks for GCEF graduates to be initiated in 2013;
  • strategic planning for local resource mobilisation to support the inclusion of girls now on the waiting lists for GCEF;
  • submission of an abstract to the ICN Congress on the impact of access to safe solar lighting on educational outcomes;
  • a budget and plan for a symposium to recognize country-based nurse volunteers and build capacity.

The workshop also included country reports; a refresher course on financial and audit management; and a session on monitoring and evaluation.

A contribution of US$ 200 helps to cover the costs of uniforms, schoolbooks, and fees for the primary education of a girl child for one year, and US$ 600 for secondary education. Approximately US$ 5000 will secure the education of a girl throughout her primary and secondary schooling years. Contributions can be made on the following secure online site: Additional information about the GCEF is available at and


Dr Kate Gerrish


Dr Miriam Hirschfeld


Dr Teresa Yin

New members join INR editorial board

With this issue, the International Nursing Review (INR) welcomes three new members to its Editorial Board, and recognizes three retiring members for their contribution to the journal's success during their many years of service.

‘The support of committed Editorial Board members is an invaluable resource for any journal editor’, stated Dr Jane Robinson, INR Editor. ‘For INR, the range and depth of members' experiences in nursing, together with their wide geographical locations around the world, have always been of tremendous assistance to me. I am deeply grateful to all past members, and warmly welcome new members to the board in 2013’.

Members who left the Editorial Board at the end of 2012 are:

  • Megan-Jane Johnstone, Professor of Nursing in the School of Nursing and Midwifery, and Director of the Centre for Quality and Patient Safety Research at Deakin University, Melbourne, Australia.
  • Una Reid, Human Resource Development Consultant, Jamaica, West Indies.
  • Lis Wagner, Professor, Research Unit of Nursing, Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark.

In 2013, three new members join the Editorial Board.

Kate Gerrish is a Professor of Nursing Research at the University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust in the U.K. Her role in both institutions is to provide leadership in nursing research and development. During a professional career spanning 30 years, she has held a variety of clinical nursing and midwifery posts in both community and hospital settings in the U.K. and Zambia. Her principal research interests span the inter-related areas of knowledge translation and nursing development. Dr Gerrish co-edited the 6th edition of The Research Process in Nursing, a seminal research text for nurses in the U.K.

Miriam Hirschfeld is a Professor in the Department of Nursing and heads the academic nursing program at Emek Yezreel College in Israel. Her interests range from multicultural nursing education and health workforce policy to family care and ethics, as well as the impact of globalization upon health. She consults and lectures on all five continents and mentors younger nurses in both developing and developed countries. Dr Hirschfeld served for nine years as the Chief Scientist for Nursing at the World Health Organization in Geneva, and then was the first nurse to be named WHO Director of Human Resources for Health.

Teresa Jeo Chen Yin is National Ombudsman at the National Ombudsman Institute in Taipei, Taiwan. Since 1999, she also has served as a member of the Nursing Consultation Committee for Taiwan's Department of Health. Dr Yin was the Second Vice President of the International Council of Nurses (ICN) from 2009–2013, and a member of the ICN Board of Directors from 2005–2009. She served as president of the Taiwan Nurses Association from 1990–1996. Her professional experience includes positions as Professor at the Institute of Community Health Nursing at National Yang-Ming University in Taiwan, and Director of the Department of Nursing at Taipei Veterans General Hospital.

Members of the Editorial Board offer invaluable service to INR, its contributors and its readers. They review manuscripts; provide extensive advice and assistance to authors to enable them to achieve publication; and promote the journal in the course of their daily work. The names and titles of all members of the Editorial Board are listed on the inside front cover of each issue.