TABLE 1. Regulatory Function Framework.

Please review the seven nursing regulatory functions (e.g., legislation, registration, licensure, etc.) together as a group, considering each stage of maturity. For each regulatory function:

• Place a checkmark in the box next to every criteria that has been achieved.
• Circle the stage you feel most accurately reflects where your country is at in development. All criteria within a stage must be met in order to circle a stage.

	Stage 1	Stage 2	Stage 3	Stage 4	Stage 5
Nursing and Midwifery Legislation	□Identification of key issues with participation of stakeholders. □Consensus around whether a new nursing and midwifery Act or amendments to existing legislation are needed.	□Legislation drafted with stakeholders including Ministry of Health, nursing and midwifery council and/or professional associations, academia, and legislature or parliament.	□Approval, commencement, and publication of legislation.	□Implementation through dissemination and training of nurses and midwives in their rights and duties. □Issuance by Councils and/or Ministry of Health of rules or regulations.	□Monitoring and evaluation of compliance and impact.
Registration System and Use of Registration Data	□Registration is not legally required for nurses and midwives to practice. OR Registration is lifelong (i.e., renewal is not required). □The register is primarily a paper-based system.	□Renewal of registration (or license) is required. □Both paper and electronic (e.g., Excel) system for registration is used. □Registration system can answer basic queries (e.g., number of midwifes in the country).	□Registration system (including licensure and re-licensure) is primarily electronic (use of software). □Database includes all public sector nurses and is regularly updated. □Registration system can be queried to generate workforce reports.	□Registration system is completely electronic and includes all public and private sector nurses. □Database displays various registration statuses of nurses and midwives. □Database can be programmed to automatically generate workforce reports.	□Registration, licensure, and relicensure services are available online or are decentralized. □Registration database can exchange data with other health information systems. □Registration data used by decision makers for workforce policy and planning.
Licensure Process	□Licenses not required to practice.	□Licenses are issued with initial registration (no separate licensure examination). □Renewal of license is required at intervals specified by the regulatory authority.	□An examination or assessment process is in place for initial registration and licensure. □The examination or assessment is paper based. □National competency standards are being developed.	□Examination or assessment content meets national competency standards. □Various statuses of licenses issued (i.e., conditional, suspended). □Licensure verification process facilitates entry of foreign educated nurses/midwives into workforce.	□Registration and initial licensure examination content is updated regularly. □Examination content aligns with global guidelines or regional competency standards. □The licensure status of a nurse or midwife is available to the public either via website, phone, or in person.
Scope of Practice (SOP)	□SOP not defined by legal statute or regulation. □SOP may be decided by the employer or based on health facility needs.	□Council has the authority to formally define the SOP. □SOP are under development. □SOP reviewed or revised within 10 years.	□Nationally standardized SOP for all nurse and midwife categories. □SOP is based on nursing/midwifery context, consultations, and job descriptions. □SOP reviewed or revised within last 5 years.	□SOP includes essential nursing/midwifery competencies. □SOP is regularly and systematically reviewed and revised. □SOP allows for individuals to make decisions about task shifting or task sharing.	□All SOP align with global guidelines and standards for nursing and midwifery. □SOP reviewed and revised according to global standards. □SOP is dynamic, flexible, and inclusive, not restrictive.
Continuing Professional Development (CPD)	□CPD does not exist. □CPD is voluntary. □CPD framework for nursing and midwifery may be in planning stages.	□Council has a mandate in legislation to require CPD. □National CPD framework for nursing and midwifery is developed. □Implementation of CPD requirement is in pilot or early stages.	□CPD program for nurses and midwives is finalized and nationally disseminated. □CPD is officially required for relicensure. □Strategy in place to promote and track compliance.	□Electronic system in place to monitor CPD compliance. □Penalties for noncompliance with CPD exist. □Available CPD includes content on national HIV service delivery guidelines for nurses and midwives.	□Multiple types of CPD are available including Web-based and mobile-based models. □CPD content aligns with regional standards or global guidelines. □Regular evaluations of CPD program carried out.
Accreditation of Preservice Education	□Council does not have legal authority to approve preservice nursing/midwifery schools or programs. □Public schools/programs may be “endorsed” by the council.	□Council has legal authority to approve preservice schools/programs. □Council issues standards for accreditation of nursing schools/programs. □No time limit or expiration date on accreditation approval.	□Initial assessment visits are carried out by the council or their designated authority. □Standards for accreditation are regularly reviewed and revised. □Requirement for accreditation renewal is enforced.	□Assessment visits are regularly carried out by an independent body. □Council has an electronic system to track accreditation status. □Various levels of accreditation granted (i.e., probationary, conditional).	□Group independent from council makes accreditation determination for both public and private schools/programs. □Accreditation standards align with global or regional guidelines. □Accreditation status available to the public.
Professional Misconduct and Disciplinary Powers	□Council does not have authority to manage complaints and impose sanctions. □Standards of professional conduct may not be defined.	□Legislation authorizes council to define standards for professional conduct. □Council has authority to investigate or initiate inquiries into professional misconduct. □Basic types of complaints and sanctions exist.	□Complaints investigation and misconduct hearings are separate processes. □A range of disciplinary measures (e.g., penalties, sanctions, conditions) exist. □Appeals processes are available and accessible.	□The processes and documentation of complaints and sanctions are transparent. □Processes and timelines are in place to review and remove penalties and sanctions. □Processes are in place for members of the public to lodge a complaint.	□Professional conduct standards align with regional standards or global guidelines. □The complaint management process is regularly evaluated for transparency and timeliness. □Information on complaints and sanctions is available to the public.