At a global level “the difficulties relating to health personnel go beyond numerical shortages. Specific issues emerge at each level of the healthcare labor market, such as poor-quality education, lack of financial resources to absorb new graduates, and difficulties in the equitable distribution and effective management of healthcare personnel. Correctly identifying issues is essential to determining positive outcomes.” Thus Giorgio Cometto, Health workforce department, World Health Organization, in his remote speech at the international conference ‘Challenges and priorities of the nursing profession in Europe and in the world’ promoted by the National Federation of Nursing Orders and Professions (Fnopi) with the patronage of Ministry of Health and with the participation of representatives of WHO Europe, today in Rome.
“Nursing staff have a central role in the WHO regulatory framework as they are the largest occupational group in the sector – explains Cometto – We are at the fifth cycle of a WHO strategic policy for nursing and midwifery staff. The organization specifically analyzes the situation of these personnel, documenting and studying the causes of the inequity in the distribution of this professional figure at the level of each national team. The strategy is based on four pillars: education, creation of adequate jobs, strengthening of strategic capabilities and optimization of the regulatory and management framework”.
In this context, “a document of guidelines on the regulation of healthcare personnel was recently created – Cometto illustrates – to offer recommendations on strengthening regulatory systems. Through a systematic analysis of the literature, it emerged that several complexities exist in regulatory systems, especially in high-income countries, with often low-quality scientific evidence. One of the biggest problems is the great diversity of regulatory systems and the fact that many studies do not thoroughly analyze the effects of regulation itself. We have also documented flexibilities introduced during the Covid-19 pandemic, maintained in some cases, and challenges facing developing countries, such as the migration of healthcare workers to wealthier markets. A common challenge concerns the discrepancy between regulatory systems and their actual application in practice.”
The recommendations of the guidelines “include the primary functions of regulation – specifies the expert – such as the definition of requirements for professional practice, the accreditation of training institutes and the management of cases of practice that does not comply with standards. Ancillary functions are also covered, such as assistance in the equitable distribution of personnel and the management of migratory flows. It is essential that regulatory systems are designed to serve the public interest and not just the professions, that they are inspired by the principle of proportionality to guarantee necessary activities during emergencies”. The principle of proportionality emerges as a “key element, recognizing that there are different strategies to guarantee the competence of healthcare personnel – he underlines – The most stringent forms of regulation, such as certification and licensing, should be reserved for roles with greater risk of harm for users”.
Among the priorities “it is fundamental to address the gap between theoretical regulation and actual practice, analyzing the causes of this discrepancy, developing strategies to optimize the application of regulation. Only by understanding the specific context and the necessary resources – he concludes – can the effectiveness of regulatory policies be monitored and improved over time”.
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