WASHINGTON, DC, USA (CMC) — The Pan American Health Organization (PAHO) is calling for an expansion of the role played by nurses in primary health care in the Americas, including the Caribbean.

A new PAHO report, released ahead of International Nurses Day today, noted that expanding the role of graduate, primary health care nurses will improve access to health care, particularly in areas with limited numbers of health care professionals.

“If we are to meet the needs of an aging population and subsequent increase in the number of non-communicable diseases, we must expand the role of nurses, who make up the majority of the region’s health-care professionals,” said James Fitzgerald, PAHO’s director of the Department of Health Systems and Services.

The report titled, “Expanding the Role of Nurses in Primary Health Care”, notes that nurses can play a “crucial role in expanding access to primary health care, and in particular, in health promotion, disease prevention and care, without leaving anyone behind.”

It is estimated that in the Americas, around 800,000 additional health care professionals are required in order to meet current needs, PAHO said, adding that the region has an inadequate distribution of health care professionals, the majority of whom are concentrated primarily in urban areas with greater economic resources.

PAHO said in the United States, for example, there are 111.4 nurses for every 10,000 citizens; whereas, in Haiti, there are only 3.5, and in half of the countries of the region, the average number of nurses per 10,000 citizens is 10.4 or fewer.

PAHO said the report emphasizes that the implementation of new roles, such as Advanced Practice Nurses (APNs), would enable a broader range of primary health care responsibilities to be carried out in vulnerable parts of cities and in remote areas.

“This would contribute to better promotion of health, disease prevention and a reduction in mortalities,” the report stated and PAHO said, in countries such as Australia, Canada, the United States, the United Kingdom, Ireland and Finland, nurses with four and five-year university degrees already carry out a broader range of responsibilities that enable them to meet patient needs.

PAHO said the concept of APN’s or nurse practitioners —nurses authorised to make diagnoses, request examinations and issue prescriptions — began in Canada and the United States during the 1960s, and these nurses practice as autonomous professionals, without supervision from a doctor, and can work within health care services or as independent practitioners.

In Latin America and the Caribbean, PAHO said there is still no regulation or training for APNs in primary health care; and issuing prescriptions, one of the central elements of this advanced practice, is still prohibited in many countries.

PAHO said Jamaica and Puerto Rico are the Caribbean countries with most developed training programmes, regulation and professional integration of APNs.

Silvia Cassiani, advisor on Nursing and Allied Health Personnel at PAHO, said “broadening the role of graduate nurses is not about substituting or replacing another professional, but about complementing other professionals while increasing efficiency, improving results and reducing cost”.

PAHO said the report offers nine recommendations for expanding the role of advanced practice nurses in the Americas, and suggests that governments, professional associations, nursing schools, health institutes, and other interested organisations “debate, implement and broaden the role of nurses in line with the needs and context of each individual country”.