The issues were a common thread of speakers at the opening of the 52nd Annual General Meeting of the RNB on Tuesday, 12 August in Barbados, where the spotlight was placed on the anticipated increase in the need for nurses and midwives, and the need for guidance and action to mitigate the impacts of the shortage.

Dr. The Most Honourable Jerome Walcott, Minister of Health and Wellness of Barbados, delivered the feature address in which he lauded the achievements of the Regional Nursing Body over the past 50 years and its unwavering commitment to nursing excellence.

“The RNB now stands at a critical crossroad. You are not only being called upon to sustain the gains of the past, but to lead the transformation of the profession, to shape new models of care, and to prepare our nursing workforce to face complex health challenges ahead, which include, of course, ‘Dr. Google’ and the worrisome effects of climate change,” the Minister said.

He pointed to the “troubling trends” and “growing concerns” about nurse retention and called for courage and collaboration in charting the course ahead.

“Too many of our nurses are leaving for greener pastures, an issue that has become more acute in recent years. Small developing states such as ours simply cannot match the salaries and benefit packages offered by the larger, wealthier nations. As a result, we are facing staffing shortages that increase nurse-to-patient ratios, create longer shifts, which can lead to stress and burnout in some cases, and ultimately can compromise the quality of patient care,” he noted.

In her remarks, Ms. Alison Drayton, Assistant Secretary-General, Human and Social Development at the CARICOM Secretariat, highlighted the “critical shortage of these indispensable health professionals.” She cited the State of the World’s Nursing Report 2025 (SOWN), which pointed out that one in seven nurses globally was practising outside of the country of their birth, underscoring a growing dependence on foreign-born nurses within high-income countries.

“This dynamic poses significant challenges to the development and sustainability of health systems in low- and middle-income countries like those within our Region. Accordingly, it is imperative that the Region substantially increase its investments in the education, recruitment, and retention of nurses and midwives to safeguard the resilience and effectiveness of our health workforce,” the Assistant Secretary-General said.

Ms. Nester Edwards, Chair of the Regional Nursing Body and Chief Nursing Officer of the Ministry of Health, Wellness and Religious Affairs of Grenada, also warned of the consequences if gaps are not filled.

“While they are among the largest, if not the largest, segment of the workforce in our healthcare systems, the Region continues to face a perennial shortage of nurses and midwives with high attrition rates and migration to more developed countries. According to the SOWN 2025 report, we are unlikely to achieve the targets for universal health coverage if the gap in these shortages is not filled,” she said.

She called for redoubled efforts to find effective strategies to recruit and retain nurses and midwives, including those in the diaspora. “Improving working conditions and utilising technological advancements and incentives, including flexible working hours, should be considered when developing these strategies,” she said.

The RNB chair also urged capacity-building of the next generation of nurses and midwives in leadership, policy development, strategic planning, and research.

Agenda items for the three-day meeting include developing an action plan to address the migration and mobility of health workers in the Region, a review of the SOWN 2025, new developments in nursing, and the results of the April 2025 sitting of the Regional Examination for Nurse Registration.

CARICOM remains steadfast in its commitment to advancing maternal and child health as a critical component of the Region’s health and development agenda, working with our Ministries of Health, the Regional Nursing Body, and bilateral and multilateral development partners.

The theme for World Health Day 2025, “Healthy Beginnings, Hopeful Futures” spotlights maternal and newborn health, and the longer-term well-being of women.

The Region has made good progress in reducing newborn and child mortality. In 2022, the neonatal and under-five mortality rates were in line with the Sustainable Development Goal (SDG) target, at 12 deaths per 1,000 live births, and 18 deaths per 1,000 live births.  Further, several Member States and Associate Members of CARICOM have been certified as having eliminated mother-to-child transmission of HIV and Syphilis (EMTCT). We must work to maintain these gains.  The work of the Pan Caribbean Partnership Against HIV and AIDS (PANCAP) has been critical to this progress.

Today, as I extend appreciation to our healthcare workers for the formidable role they play in safeguarding lives and, by extension, the future of our Region, I note that there is much more work to be done.  I urge all stakeholders to intensify efforts to provide universal access to quality maternal healthcare. Addressing the many risk factors that women face during pregnancy, including socioeconomic status, education, ethnicity, and geographical location, is critical.

The target of reducing maternal mortality to below 70 per 100,000 live births is within reach. Diligent, collective action will ensure that all women in our Community will have equitable access to safer and evidence-based reproductive health practices.  Continued investment to strengthen our healthcare infrastructure and systems, including antenatal and postnatal care, community health initiatives, and a workforce that supports reproductive, maternal, neonatal, and child health services are key considerations. So too, is empowering women, through health and reproductive rights education, to lay the groundwork for healthier futures for their children and families.

The Caribbean Community stands at a critical juncture in our collective journey towards improving health outcomes for mothers and newborns.  The COVID-19 pandemic adversely impacted our health systems and disrupted our hard-won progress, and climate-related challenges continue, but the lessons learned serve as a call to action to safeguard the future of our families and communities.

CARICOM remains steadfast in its commitment to advancing maternal and child health as a critical component of the Region’s health and development agenda, working with our Ministries of Health, the Regional Nursing Body, and bilateral and multilateral development partners.

In March this year, the CARICOM Secretariat supported the launch of a new initiative from the Pan American Health Organization (PAHO) to strengthen strategies to eliminate key diseases affecting maternal and child health. The Secretariat will continue to support regional initiatives which prioritise maternal and child health, and the survival of newborns.

The commitment to achieve the SDGs, specifically Goal 3, which strives to end preventable deaths of mothers and children, must be unwavering. Let us draw inspiration from our resilient communities and dedicated healthcare workers, and continue to create the path to a future where every mother and child thrives.

“The Regional Nursing Body discussed a number of policies and tools aimed at significantly improving the level of care provided by nurses in the Region. The body continued the work towards completing the revision of the Caribbean Standards for Nursing and Midwifery Education and Practice to ensure that these standards were harmonised throughout the Region and remained consistent with international policies and guidelines. This would ensure that nursing and midwifery professionals were better equipped to serve the population of the Community.”

The Regional Nursing Body (RNB) is on a trajectory to improve health outcomes for the people of the Caribbean Community through harmonising standards, training, and assessment tools for nurses. This was the focus of four days of discussions by stakeholders in the nursing profession, which took place at the CARICOM Secretariat’s Headquarters in Georgetown, Guyana.

Thirty-one (31) policy and clinical management professionals participated in the Fifty-Third Joint Meeting of the Executive and Education Committees and the Twenty-Second Meeting of the Practice Committee of the RNB under the chairmanship of Ms Nester Edwards, Chief Nursing Officer from the Ministry of Health, Wellness and Religious Affairs of Grenada.    

In her address to the meeting, Ms Helen Royer, Director of Human Development at the CARICOM Secretariat, emphasized the unwavering commitment of stakeholders to advancing quality in nursing, underscoring the dedication that is evident in the nursing community:

“The Regional Nursing Body discussed a number of policies and tools aimed at significantly improving the level of care provided by nurses in the Region. The body continued the work towards completing the revision of the Caribbean Standards for Nursing and Midwifery Education and Practice to ensure that these standards were harmonised throughout the Region and remained consistent with international policies and guidelines. This would ensure that nursing and midwifery professionals were better equipped to serve the population of the Community,” stated the Director.

Dr Serena Bender-Pelswijk, Deputy Programme Manager for Health Sector Development at the CARICOM Secretariat, underscored the integral role of these discussions in developing and refining the tools and policies used to advance the nursing profession in the Region.

“Participants are discussing the development of Standards for the education, practice and regulation of the ‘Advanced Practice Nurse’ considering the expansion of the specialties in the nursing profession in response to the evolving needs of the healthcare systems in the Region. In addition, the meeting received a presentation by the World Health Organisation on the Human Resources for Resilient Health Systems Caribbean Roadmap 2025,” added Dr Bender-Pelswijk.

The RNB, as the advisory body on matters related to the education, practice and regulation of nurses and midwives, plays a crucial role in improving nursing and its contribution to health care in the Region. It also provides advisory services to Member States on request and as mandated by the Conference of Ministers responsible for health, ensures that nursing standards are constantly evolving and improving.

The RNB identifies the need for basic, post-basic, and continuing nursing education programmes that align with current trends in nursing and health care in the Region. Among other strategic objectives, it promotes developing, implementing, and evaluating quality assurance programmes in nursing and health care.

“CARICOM Heads of Governments expressed deep concern about the high levels of crime and violence in the Region, driven in part by firearms and ammunition trafficking, transnational criminal networks, and a breakdown of social structures, and the impact of crime and violence on young people and children.”

CARICOM Secretariat, Turkeyen, Greater Georgetown, Guyana – Tuesday, 1 October 2024: CARICOM Heads of Government are prioritising the safety and security of the Region and working collaboratively to address the social determinants that contribute to many social ills, including crime and violence, that adversely impact public health, families, communities, and individuals. These are the sentiments of Dr. Armstrong Alexis, Deputy Secretary-General of CARICOM, during his address at the Forty-Seventh Meeting of the Council of Human and Social Development (COHSOD) – Health on Friday, 27 September, in Washington, D.C.

The Meeting was convened under the chairmanship of Hon. Cassanni Laville, Minister of Health, Wellness and Social Services of Dominica. CARICOM Ministers of Health, Chief Medical Officers, national health officials, and representatives from Regional Institutions and Bodies, including the Caribbean Public Health Agency (CARPHA), the Regional Nursing Body (RNB), and the Human Resources for Health Caribbean Commission, were in attendance. Regional and international partners, the Global Fund and Pan American Health Organization (PAHO)/World Health Organisation (WHO) also participated.

The Meeting focused on advancing the public health agenda in the Caribbean. Critical discussions surrounded regional health security, including an update on matters of interest to the Region for the upcoming PAHO Directing Council and Crime and Violence as a Public Health Concern, formally presented for discussion and consideration by Saint Kitts and Nevis. Hon. Dr. Terrance Drew, Prime Minister of Saint Kitts and Nevis is responsible for human resource development, health, and HIV and AIDS in the CARICOM Quasi Cabinet.

The Deputy Secretary-General reminded the Meeting that CARICOM Heads of Governments expressed “deep concern about the high levels of crime and violence in the Region, driven in part by firearms and ammunition trafficking, transnational criminal networks, and a breakdown of social structures, and the impact of crime and violence on young people and children.”

He highlighted that in a statement issued following the 47th Heads of Government Conference in July 2024, the Heads of Government reaffirmed their commitment to taking urgent action to protect the citizens of the Region and to ensure safety, security, and public interest by sharing information and strengthening legislation related to firearms offences, violent crime, and bail.

Dr Alexis also lauded the offer by Barbados to host a second Regional Symposium on Crime and Security as a Public Health Issue before the end of 2024. “The presentation today by Saint Kitts and Nevis Chief Medical Officer Hazel Laws on behalf of Prime Minister Drew as the Lead Head with responsibility for issues pertaining to Human Resource Development, Health, and HIV and AIDS in the CARICOM Quasi Cabinet further attests to the importance that Heads of Governments have placed on identifying strategic solutions to tackle crime and violence,” added the DSG.

This Meeting is integral to the continued leadership and strategic direction of the Region’s health sector development and the collaborative approach to managing on-going health threats within the Community.

-ENDS-

EDITOR’S NOTES:

Other critical issues discussed at the Meeting:

The discussion also centered on human resources for health including the Policy on Migration and Mobility of Health Workers in the Caribbean and a Draft Policy on the Number of Chances to Re-sit the Regional Examination for Nurse Registration. In addition, the CARICOM Secretariat presented an update on the establishment of a memorandum of understanding between CARICOM and the Health Development Partnership for Africa and the Caribbean (HeDPAC). On the issue of resources for advancing regional priorities, the Pan Caribbean Partnership against HIV and AIDS led a discussion on the implications for reduced donor funding for the HIV and AIDS response in the Region.

Intense discussions surrounded disease surveillance highlighted by a presentation by CARPHA on epidemiological trends in infectious diseases and their implications for Policy as well as the expanding and institutionalizing of the novel Cricket World Cup Mass Gatherings Surveillance tool for improving emergency response in the Caribbean.

Participants also received an update on matters pertaining to the Port-of Spain Declaration including a review of non-communicable disease (NCD) progress since the 2007 Port-of-Spain Declaration towards the 4th UN High-Level Meeting on NCDs in 2025 and a report on the outcomes of the PAHO Regional Meeting on cervical cancer and implications for Member States.

Climate Change and Health was also a significant concern for Ministers of Health following a report on the evaluation of the Caribbean Action Plan on Health and Climate Change and the future vision for climate and health in the Caribbean by PAHO/WHO.

Participants of the Forty-Seventh Meeting of the Council of Human and Social Development (COHSOD) – Health. CARICOM Deputy Secretary-General, Dr. Armstrong Alexis (seated, centre) and Chair of COHSOD-Health and Minister of Health, Wellness and Social Services of Dominica – Hon. Cassanni Laville (seated, extreme left)

Related links

Statement by the Chair of the Caribbean Community, Honourable Dickon Mitchell, Prime Minister of Grenada on increasing vigilance following the Mpox outbreak
https://caricom.org/statement-by-the-chair-of-the-caribbean-community-honourable-dickon-mitchell-prime-minister-of-grenada-on-increasing-vigilance-following-the-mpox-outbreak/

CARPHA Urges Member States to be Vigilant Following WHO Declaration of a Public Health Emergency of International Concern for Mpox
https://carpha.org/More/Media/Articles/ArticleID/902/CARPHA-Urges-Member-States-to-be-Vigilant-Following-WHO-Declaration-of-a-Public-Health-Emergency-of-International-Concern-for-Mpox

CARICOM Development Fund Provides initial US$100,000 cash contribution to Hurricane Beryl Recovery Efforts in St. Vincent and the Grenadines
https://caricom.org/caricom-development-fund-provides-initial-us100000-cash-contribution-to-hurricane-beryl-recovery-efforts-in-st-vincent-and-the-grenadines/

Hurricane Beryl dealt ‘serious blow’ to Grenada’s 25 by 2025 progress – PM Mitchell
https://caricom.org/hurricane-beryl-dealt-serious-blow-to-grenadas-25-by-2025-progress-pm-mitchell/

“The development of robust, responsive, and resilient health systems cannot be achieved without the involvement of nurses, midwives and other related sectors.”

Monday 19 August 2024 (CARICOM Secretariat, Turkeyen, Greater Georgetown): The advancement of nursing and midwifery policies and plans to improve the quality of nursing education and practice within the Caribbean Community was the focus of the 51st Annual General Meeting of the Regional Nursing Body (RNB).

The CARICOM Secretariat, in collaboration with the Ministry of Health and Wellness of Belize, hosted the meeting from 5 to 7 August at the San Ignacio Resort in the Cayo District, Belize. The Hon. Kevin Bernard, Belize’s Minister of Health and Wellness; Dr Julio Sabido, Chief Executive Officer, Ministry of Health and Wellness of Belize; Chief Nursing Officers from the Region, Nursing Council representatives and other public health stakeholders were in attendance.

The three-day event facilitated deliberations on critical public health issues related to the education and practice of nursing and midwifery, including the results of the April sitting of the Regional Examination for Nurse Registration (RENR), development of the Draft Policy to address the migration of healthcare workers in the Caribbean, harmonisation of midwifery education and practice, and progress made in updating the Standards for Nursing Education and Practice.

Nurses and other public health practitioners also provided input on the Draft Policy Brief on the Number of Chances to Re-sit the RENR. This policy will help to improve the accessibility of the examination to candidates and increase their chances of entering the healthcare workforce.

In her remarks, which were delivered virtually, Ms Helen Royer, Director of Human and Social Development at the CARICOM Secretariat, highlighted that Hurricane Beryl devastated and disrupted the lives of people in the affected Member States, a stark reminder of the need for the development of robust, responsive, and resilient health systems.

“This cannot be achieved without the involvement of nurses, midwives and other related sectors,” stated Ms Royer. “The Secretariat reiterates its expression of solidarity and support for the affected Member States. Our solidarity also remains with Ms Nester Edwards, Chief Nursing Officer of Grenada and Chair of the Regional Nursing Body, who was unable to attend this meeting. I have looked at the various country reports and have taken note of the cross-cutting issues that we are tackling, which will require a holistic and collaborative effort.”

The Director emphasised that the CARICOM Secretariat remains committed to fully supporting the RNB’s initiatives and development through policy advancement, advocacy, and strategic collaboration, with the overarching aim of better health outcomes for the people of the Caribbean Community.

Helpful links:

What is the Regional Nursing Body?

https://uia.org/s/or/en/1100056832