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Global Health Alumnus' Research Helps Countries Improve Primary Health Care in Latin America

David Oldenburger

MSc Global Health alumnus David Oldenburger.

June 28, 2017

Broadening the scope of nursing practice will improve primary health care in the Americas, says MSc Global Health program alumnus David Oldenburger, who has developed a strategy to help put the wheels in motion. In his recently published paper, Implementation strategy for advanced practice nursing in primary health care in Latin America and the Caribbean, Oldenburger outlines a nine-step plan designed to help countries introduce the role of the advanced practice nurse (APN) to healthcare systems in Latin America and the Caribbean.

“Unlike in Canada and the US, the APN role is a new concept in the Americas, and this strategy aims to overcome barriers to implementation,” explains Oldenburger, whose paper is an outcome of a Pan American Health Organization/World Health Organization (PAHO/WHO) summit, hosted by McMaster University’s PAHO/WHO Collaborating Centre in 2015. The summit focused on PAHO’s strategy to increase the number of primary health care providers, including APNs, in Latin America as part of its goal to achieve universal health coverage, which advocates for the right to quality health for all people.

As Oldenburger points out, this research has been a collaborative effort between nursing experts and APN researchers from across Canada and the USA, including Andrea Baumann and Ruta Valaitis, director and deputy director of the PAHO/WHO Collaborating Centre at McMaster. The team followed an evidence-based approach developed by McMaster professor Denise Bryant-Lukosius to organize objectives from the summit.

The implementation strategy highlights the importance of clearly defining the role of the APN and the role within a specific context, and identifying patient populations in need of primary healthcare providers. It also addresses key challenges associated with APN implementation, including differences in health services delivery in the Americas. “For example, the disease-oriented approaches in Latin America aren’t aligned with the patient-centered, health-oriented perspective of APN practice,” explains Oldenburger.

Despite these barriers, Oldenburger is confident that countries can improve quality care by being committed to human resources for health, and by collaborating with countries like Canada.  “In Canada, we’ve relied on advanced practice nurses for decades, so we know first hand the ways in which they provide high-quality care and improve patient satisfaction and health outcomes. We have a lot of key learning we can share.”

Since the 2015 summit, PAHO/WHO stakeholders have held several meetings and follow-up APN summits to assist countries as they begin to put the nine-step strategy in place and introduce the APN role in their specific health care contexts.