Roles and responsibilities of government chief nursing and midwifery officers in the Americas

Objectives: To analyze the roles, responsibilities and scope of current government chief nursing and midwifery officers or equivalent senior leaders in the Region of the Americas. Methods: This was a descriptive observational study. All government chief nursing or midwifery officers or equivalent senior leaders from 35 countries in the Region of the Americas were considered eligible to participate. An online survey was conducted that included items on demographic variables, the officer's roles and responsibilities, and a self-assessment of competencies. Data were analyzed using descriptive statistics, disaggregated by role, subregion and country income level. Content analysis was used for responses to open-ended questions. Results: Twenty eight officers from 28 countries participated in this study, representing 80% of the 35 countries in the Americas. About 82.1% (23/28) of the officers or equivalent leaders were exclusively responsible for nursing issues. Most of the participants had the job title of chief nursing officer (53.6%, 15/28), were female (92.9%, 26/28) and were aged 55-64 years (46.4%, 13/28). Regarding leadership roles, 57.1% (16) of participants reported that their countries had an executive model, with the officer having line authority over nursing or midwifery, or both. The responsibilities of these officers were mainly related to leadership, influence and policy advice. In the self-assessment of competencies, participants rated themselves as less skilled in global health priorities and management. Conclusions: Although the role of a government chief nursing officer or midwifery officer exists in most countries in the Americas, there is a need to further strengthen it. It is important for governments and stakeholders to create a policy environment conducive to empowering these leaders, recognizing their strategic role in the human resources for health agenda, and in expanding the contributions of nursing and midwifery towards achieving more resilient and equitable health systems.