ABSTRACT

This article provides a commentary on the Pan American Network of Nursing and Midwifery Collaborating Centres (PANMCC). The objectives are to present an overview of the formation and evolution of the network, its impact on education, research, policy and communication and the benefits of membership. The advantages of international networks as a mechanism to strengthen nursing and midwifery workforces and improve health systems are also highlighted. The Pan American Health Organization (PAHO), the World Health Organization (WHO) Office in the Americas, oversees collaborating centres in the Region. Established in 1999, PANMCC consists of 17 centres situated in universities and schools of nursing. These centres provide crucial nursing and midwifery input to PAHO/WHO. The network supports global engagement and capacity building via collaboration, resource sharing and research colloquia. The linkages within the network enhance professional development, increase capacity building and heighten visibility of PANMCC and the work of its members.

Keywords
Capacity building; midwifery; nursing; health consortia

RESUMEN

En este artículo se presenta un comentario sobre la Red Panamericana de Centros Colaboradores de Enfermería y Partería (PANMCC, por su sigla en inglés). Los objetivos son presentar una visión general de la formación y evolución de la red, sus repercusiones en los ámbitos de la educación, la investigación, la política y las comunicaciones, así como los beneficios de pertenecer a la red. También se destacan las ventajas de las redes internacionales como mecanismo para fortalecer al personal de enfermería y partería y mejorar los sistemas de salud. La Organización Panamericana de la Salud (OPS), Oficina Regional de la Organización Mundial de la Salud (OMS) para las Américas, supervisa los centros colaboradores en la Región. Fundada en 1999, la PANMCC consta de 17 centros ubicados en universidades y facultades de enfermería, los cuales proporcionan información crucial sobre enfermería y partería a la OPS/OMS. Esta red respalda el compromiso general y el desarrollo de capacidades mediante la colaboración, el intercambio de recursos y los coloquios de investigación. Los vínculos en la red mejoran el desarrollo profesional, aumentan el desarrollo de capacidades y aumentan la visibilidad de la PANMCC y el trabajo de sus miembros.

Palabras claves
Creación de capacidad; partería; enfermería; consorcios de salud

RESUMO

Este artigo traz um comentário sobre a Rede Pan-Americana de Centros Colaboradores de Enfermagem e Obstetrícia (PANMCC). Os objetivos são apresentar uma visão geral da formação e evolução da Rede, seu impacto em educação, pesquisa, políticas e comunicação e os benefícios da filiação. Também são destacadas as vantagens das redes internacionais como mecanismo para valorizar as forças de trabalho em enfermagem e obstetrícia e melhorar os sistemas de saúde. A Organização Pan-Americana da Saúde (OPAS) – o Escritório da Organização Mundial da Saúde (OMS) nas Américas – supervisiona os Centros Colaboradores na região. Criada em 1999, a PANMCC é composta por 17 centros situados em universidades e escolas de enfermagem. Esses centros fornecem informações essenciais sobre enfermagem e obstetrícia para a OPAS/OMS. A rede apoia o envolvimento global e o fortalecimento institucional por meio de colaboração, compartilhamento de recursos e colóquios de pesquisa. Os elos dentro da rede aprimoram o desenvolvimento profissional, estimulam o fortalecimento institucional e aumentam a visibilidade da PANMCC e do trabalho dos seus membros.

Palavras-chave
Fortalecimento institucional; tocologia; enfermagem; consórcios de saúde

There are more than 800 World Health Organization (WHO) Collaborating Centres (CCs) in 80 Member States around the globe. As defined by WHO, a "Collaborating Centre is an institution designated by the Director-General of WHO to form part of an international collaborative network set up by WHO in support of its programme at the country, intercountry, regional, interregional and global levels" (¹1. World Health Organization. Collaborating centres. Geneva: WHO; 2022 [cited 20 March 2022]. Available from: https://www.who.int/about/collaboration/collaborating-centres
https://www.who.int/about/collaboration/... ). The Centres were launched in 1947 to advance world health, promote research and strengthen country resources (¹1. World Health Organization. Collaborating centres. Geneva: WHO; 2022 [cited 20 March 2022]. Available from: https://www.who.int/about/collaboration/collaborating-centres
https://www.who.int/about/collaboration/... ). Eligibility is open to healthcare facilities, agencies and higher education institutions, which are designated by WHO as CCs based on their excellence and technical expertise in research and education that aligns with WHO goals. The Centres are organized by fields, including occupational health, primary care, advanced practice nursing and midwifery development (²2. Pan American Network of Nursing & Midwifery Collaborating Centers. About. Birmingham, AL: PANMCC; [date unknown] [cited 25 April 2022]. Available from: https://panmcc.org/about/
https://panmcc.org/about/... ).

The WHO first established CCs in schools of nursing in the 1970s, and there are currently 47 Centres engaged in funded projects, educational partnerships and research focusing on building expertise in nursing and midwifery (³3. World Health Organization. Fact sheets: nursing and midwifery. Geneva: WHO; 2022 [cited 20 March 2022]. Available from: https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery
https://www.who.int/news-room/fact-sheet... ). Specific activities include supporting baccalaureate and doctoral study in nursing and midwifery and consensus building regarding standards of practice. There is an understanding within WHO and across the CCs that education, professional development and collaboration in nursing and midwifery can save resources, reduce unnecessary interventions and improve the quality of care (⁴4. World Health Organization. State of the world's nursing 2020: investing in education, jobs and leadership. Geneva: WHO; 2020 [cited 28 April 2022]. Available from: https://www.who.int/publications/i/item/9789240003279
https://www.who.int/publications/i/item/... ).

The Pan American Health Organization (PAHO), the WHO Regional Office for the Americas (AMRO), receives applications for CCs and oversees designees. This article provides a commentary on the Pan American Network of Nursing and Midwifery Collaborating Centres (PANMCC). The objectives are to present an overview of the formation and evolution of the network, its impact on education, research, policy and communication and the benefits of membership. The advantages of international networks as a mechanism to strengthen nursing and midwifery workforces and improve health systems are also highlighted.

PAN AMERICAN NETWORK OF NURSING AND MIDWIFERY COLLABORATING CENTRES

Formation and evolution

Created in 1999, PANMCC has 17 member CCs and provides information on workforce trends, education and health issues to PAHO/WHO. It also champions "the role of nurses and midwives in the advancement of 'Universal Health Coverage' by addressing current health priorities and promoting regional and global cooperation" (²2. Pan American Network of Nursing & Midwifery Collaborating Centers. About. Birmingham, AL: PANMCC; [date unknown] [cited 25 April 2022]. Available from: https://panmcc.org/about/
https://panmcc.org/about/... ). PAHO advisors work with each Centre to establish terms of reference in line with PAHO/WHO priorities and these shape the nature and goals of projects undertaken by the Centres.

PANMCC was established by representatives of CCs in the AMRO Region as an informal, voluntary group. In an effort to increase collaboration and sustainability, a more formal structure was later established. The original broad goals included nursing and midwifery input to PAHO/WHO and advancing the work and visibility of these professions. Outcomes of the work and projects undertaken by each CC are documented in annual reports to PAHO/WHO, papers published by the Centres and policy documents produced by PAHO/WHO and nursing and midwifery organizations. There is also an annual meeting of all the Centres, followed by a research colloquium. The latter includes presentations, poster sessions and workshops in English, Spanish and Portuguese. The colloquium provides a forum for participants to discuss issues and trends in nursing and midwifery, create professional and academic connections through networking and identify opportunities for joint research.

The mission and objectives of PANMCC include identifying and maximizing the strengths of each Centre and fostering collaboration among them. Dr. Rita Carty, the first Director of the network, emphasized the potential power of bringing people together. The projected outcomes of collaboration include honing the skills of nursing and midwifery faculty and encouraging interest in evidence-based nursing and midwifery practice and research, student exchanges among CCs and schools of nursing and support for baccalaureate and graduate programs in countries where tertiary education (i.e., at the college or university level) was absent or limited.

To ensure recognition of and respect for the diversity of nurses and midwives in the Americas, it was mandated that the Executive Committee include officers from North and South America and that membership dues are scaled to country economies. Each CC in the network has a distinct specialty focus (Table 1).

PANMCC is a member of the WHO Global Network of Collaborating Centres for Nursing and Midwifery, which spans six regions: Africa, Americas, Eastern Mediterranean, Europe, South-East Asia and Western Pacific. It maintains relationships with key nursing and midwifery associations such as the International Council of Nurses and the International Confederation of Midwives, which liaise with non-governmental organizations and agencies, healthcare organizations and community groups worldwide.

Influence of the network

Collaborating Centres are vital given that nurses and midwives are underrepresented in regional and national dialogues related to key issues such as universal healthcare, health workforce planning and policy (⁵5. Kuokkanen L, Leino-Kilpi H. Power and empowerment in nursing: three theoretical approaches. J Adv Nurs. 2000;31(1):235-41. Available from: doi:10.1046/j.1365-2648.2000.01241.x.
https://doi.org/10.1046/j.1365-2648.2000... , ⁶6. Ndirangu EW, Sarki AM, Mbekenga C, Edwards G. Professional image of nursing and midwifery in East Africa: an exploratory analysis. BMC Nurs. 2021;20(1):37. Available from: https://doi.org/10.1186/s12912-020-00531-w.
https://doi.org/10.1186/s12912-020-00531... ). The linkages within the network enhance professional development, increase capacity building and heighten visibility of PANMCC and the work of its members. For example, PANMCC researchers published a number of jointly written articles in various high-ranking journals in 2021, including Lancet Global Health, Revista Latino-Americana de Enfermagem, International Journal of Mental Health Nursing and BMC Nursing. The articles focused on studies related to nurse staffing and patient outcomes in Chile (⁷7. Aiken LH, Simonetti M, Sloane DM, Cerón C, Soto P, Bravo D, et al. Hospital nurse staffing and patient outcomes in Chile: a multilevel cross-sectional study. Lancet Glob Health. 2021;9(8):e1145-153. Available from: https://doi.org/10.1016/S2214-109X(21)00209-6.
https://doi.org/10.1016/S2214-109X(21)00... ), an online community of practice for nurses and midwives (⁸8. Chu H, Gresh A, Bolanos V, Reynolds N. Content analysis of the Global Alliance for Nursing and Midwifery discussion forum: an online community of practice. Rev Lat Am Enfermagem. 2021;29:e3431. Available from: https://doi.org/10.1590/1518-8345.4878.3431.
https://doi.org/10.1590/1518-8345.4878.3... ), nursing students' attitudes regarding alcohol use in four countries (⁹9. Diaz Heredia LP, de Vargas D, Ramírez EGL, Naegle M. Nursing students' attitudes towards alcohol use disorders and related issues: a comparative study in four American countries. Int J Ment Health Nurs. 2021;30(6):1564-74. Available from: https://doi.org/10.1111/inm.12906.
https://doi.org/10.1111/inm.12906... ) and academic service-learning nursing partnerships (¹⁰10. Markaki A, Prajankett OO, Shorten A, Shirey MR, Harper DC. Academic service-learning nursing partnerships in the Americas: a scoping review. BMC Nurs. 2021;20(1):179. Available from: https://doi.org/10.1186/s12912-021-00698-w.
https://doi.org/10.1186/s12912-021-00698... ).

Innovative activities and successful outcomes in education, research, policy and communication have emerged from the relationships established within PANMCC and the collective nursing and midwifery expertise of its members (¹¹11. Pan American Network of Nursing & Midwifery Collaborating Centers. Activities. Birmingham, AL: PANMCC; [date unknown] [cited 17 August 2022]. Available from: https://panmcc.org/activities/
https://panmcc.org/activities/... ). Highlights include the following:

• Supporting the Safe Motherhood Initiative - Several organizations, including PAHO, the United Nations and Ministries of Health, have worked together to reduce maternal mortality and achieve universal access to reproductive healthcare (¹²12. The Safe Motherhood Initiative. Integration. 1992;(34):23. Available from: PMID: 12317829.).

• Contributing to the HIV Network - Through ongoing dialogue between Johns Hopkins University School of Nursing and the Global Alliance of Nursing and Midwifery (GANM).

• Conducting nursing mental health projects - The University of Alberta in Canada and the University of Maryland in the United States collaborated in research focusing on nurses in Central and South America.

• Participating in the GANM - This network, of which PANMCC is a member, provides nurses and midwives with "equitable access to knowledge and discussions regardless of internet bandwidth … [and provides] a global voice" (¹³13. John Hopkins School of Nursing. PAHO/WHO Collaborating Center for Nursing Knowledge, Information Management & Sharing. Baltimore, MD: JHU: 2022 [cited 28 April 2022]. Available from: https://ganm.nursing.jhu.edu/tag/global-alliance-for-nursing-and-midwifery/
  https://ganm.nursing.jhu.edu/tag/global-... ).

• Promoting the advanced practice nursing (APN) strategy - Intended to "guide and support the introduction of primary health care APN roles in Latin America and the Caribbean" (¹⁴14. Oldenburger D, Cassiani SHB, Bryant-Lukosius D, Valaitis RK, Baumann A, Pulcini J, et al. Implementation strategy for advanced practice nursing in primary health care in Latin America and the Caribbean. Rev Panam Salud Publica. 2017;41:e40. Available from: https://doi.org/10.26633/RPSP.2017.40.
  https://doi.org/10.26633/RPSP.2017.40... ).

• Collaborating to strengthen a midwifery program at the University of West Indies and doctoral study at Pontificia Universidad Católica de Chile Escuela de Enfermería.

• Providing country-specific nursing and midwifery human resource data for a variety of PAHO/WHO publications.

• Creating a compendium of best practices in nursing in Brazil to facilitate universal access to health.

• Developing a health human resource plan for Barbados.

• Producing and implementing a campaign to improve the image and visibility of nursing in Mexico.

• Advancing health equity through interprofessional projects, collaborations and a learning network that focuses on global innovations in health.

• Translating three WHO books on core competencies for midwifery: Midwifery educator core competencies; Midwifery educator core competencies: Building capacities of midwifery educators; and Midwifery educator core competencies: Adaptation tool (¹⁵15. World Health Organization. Midwifery educator core competencies. Geneva: WHO; 2013 [cited 17 August 2022]. Available from: https://apps.who.int/iris/bitstream/handle/10665/325769/9789241506458-spa.pdf
  https://apps.who.int/iris/bitstream/hand...
  
  16. World Health Organization. Midwifery educator core competencies: building capacities of midwifery educators. Geneva: WHO; 2014 [cited 17 August 2022]. Available from: https://apps.who.int/iris/bitstream/handle/10665/325770/9789241508223-spa.pdf
  https://apps.who.int/iris/bitstream/hand... -¹⁷17. World Health Organization. Midwifery educator core competencies: adaptation tool. Geneva: WHO; 2014 [cited 17 August 2022]. Available from: https://apps.who.int/iris/bitstream/handle/10665/325775/9789241508230-spa.pdf
  https://apps.who.int/iris/bitstream/hand... ).

BENEFITS OF MEMBERSHIP

Collaborating Centres "are an essential and cost-effective cooperation mechanism … [via which] WHO gains access to top centres worldwide and the institutional capacity to ensure the scientific validity of global health work" (1, p10, p11). Membership in PANMCC is beneficial for increasing the visibility and recognition of nursing and midwifery as critical professions and increasing opportunities for knowledge exchange.

Mentorship has remained a central tenet of PANMCC from its inception. Senior level personnel share their leadership experience with other members. Collaborating Centres with grant writing expertise strengthen capacity by sharing their expertise with other institutions that lack human resources and funding infrastructures. Nursing and midwifery education are supported by faculty development and research is promoted in biennial colloquia and conferences in the United States, the Caribbean and Latin America where Centres exchange data, recruit new researchers, mentor students and create teams for future grant submissions.

A convergence of evidence demonstrates that international collaboration has a significant impact on scholarly and scientific progress (¹⁸18. Babour A, Alzamzami O. International publication trends and collaboration impact on the scientific research of Saudi Arabia. J of Sciento Res. 2021; 10(3): 328–36. Available from: doi:10.5530/jscires.10.3.49.
https://doi.org/10.5530/jscires.10.3.49...

19. de Lima C, Paiva BSR, Dos Santos Neto MF, Hui D, Perez-Cruz PE, Zimmermann C, et al. The impact of international research collaborations on the citation metrics and the scientific potential of South American palliative care research: bibliometric analysis. Ann Glob Health. 2021;87(1):32. Available from https://doi.org/10.5334/aogh.3158.
https://doi.org/10.5334/aogh.3158... -²⁰20. Owens B. The benefits and challenges of international research collaboration. University Affairs. 7 November 2018. https://www.universityaffairs.ca/features/feature-article/the-benefits-and-challenges-of-international-research-collaboration/
https://www.universityaffairs.ca/feature... ). PANMCC developed an online repository of PAHO and member resources that highlight each Centre's specialty areas. This is accessible on a shared website linked to an archive of information. Every four years a CC is nominated to host the website and be the locus of communication among members, PAHO, WHO and the Nursing and Midwifery Global Communities of Practice.

Collaborating Centre designation provides opportunities for host institutions to highlight nursing and midwifery and raises the profiles of these professions within the institutions. Nursing and midwifery faculty use the CC to sponsor important events and showcase international research and education projects. The Centres serve as training hubs for students and maintain connections to PAHO, a rich resource of educational materials in three languages (English, Portuguese and Spanish). The Centres enable affiliated personnel and faculty to participate in international collaborations and consultations, which provide local and national input on healthcare policy, practice and research.

CONCLUSION

The purpose of this commentary is to provide an overview of PANMCC, its impact and the benefits of membership for CCs within the AMRO Region. More than 20 years following its establishment, PANMCC has grown in size and scope with the addition of new members and establishment of CCs in Latin America. Yet its mission and objectives have remained relevant and its goals and projects support PAHO/WHO priorities.

The WHO has identified the importance of maximizing the capacities and potential of nurses and midwives in intraprofessional and interprofessional partnerships, education and continuing professional development. PANMCC recognizes and endorses baccalaureate and graduate programs in nursing and midwifery as critical to global health systems and healthcare outcomes. Network members are contributing to nursing and midwifery curricula and research and promoting the need for higher education and excellence in educational standards. The activities, collaborations and work of the CCs help strengthen in-country health human resources and contribute to national health development.

Disclaimer.

Authors hold sole responsibility for the views expressed in the manuscript, which may not necessarily reflect the opinion or policy of the Revista Panamericana de Salud Pública / Pan American Journal of Public Health and/or those of the Pan American Health Organization.

REFERENCES

Publication Dates

History