Nurses Achieving the Sustainable Development Goals: The United Nations and Sigma

Abstract

This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article highlights SDGs 5 (gender equality), 8 (decent work and economic growth), and 17 (partnerships for the goals), along with the advocacy of these goals by Sigma Theta Tau International Honor Society of Nursing in the UN system.

In July 2012, the United Nations (UN) Economic and Social Council (ECOSOC) granted special consultative status to Sigma Theta Tau International Honor Society of Nursing—an organization with over 135,000 active members in over 100 countries that represents nurse leaders from approximately 540 chapters at more than 700 institutions.¹ This UN designation recognizes Sigma’s expertise in nursing and global health, and its commitment to the UN Charter, which promotes international cooperation among countries and sectors toward solving humanitarian issues. Special consultative status grants Sigma privileges and access to nearly all intergovernmental processes at the UN.

As part of this affiliation, Sigma provides a strong nursing presence at the UN and conducts outreach around the world to help nurse leaders better understand and contribute to the aims of the UN, including the 17 Sustainable Development Goals (SDGs), which call for local, measurable, and sustainable actions by individuals and institutions. For example, Sigma UN liaisons and youth representatives regularly offer position statements, serve as subject matter experts, and host meetings and side events during annual meetings of the Commission on the Status of Women, the High-Level Political Forum on Sustainable Development, and the UN General Assembly.

Each of the 17 SDGs are important to nurses locally and globally because they represent social, environmental, and political determinants of health and well-being.² This article highlights three of these goals: SDG 5 (gender equality), SDG 8 (decent work and economic growth), and SDG 17 (partnerships for the goals), and offers recommendations for nurses to put these into action (see Table 1).

Table 1.

Recommendations for Translating the SDGs into Action

Sustainable Development Goals (SDGs)	Recommendations
SDG 5: Gender Equality	Speak at local policy forums regarding pay equity for women and men. patients and their families on the importance of health care access and insurance. Screen for intimate partner violence, provide support and options. Speak out when you believe a girl or woman is being trafficked for sex. Testify at your state capitol regarding policy issues impacting women and girls. Include lesbian, bisexual, and transgender women in your advocacy language and initiatives. Become a nurse leader in organizations, professional associations, and local institutions.
SDG 8: Decent Work and Economic Growth	Precept students and new graduates as an investment in the profession. Promote positive, safe, and healthy work environments through deliberate practices such as workplace wellness programs. Increase the nursing profession’s visibility through social media. Invest in continuing nursing education. Encourage career pathway progression and postgraduate education. Raise your voice by voting or joining a professional nursing organization.
SDG 17: Partnerships for the Goals	Serve on a corporate or health-related board to bring nursing expertise to the team. Submit your credentials to the Nurses on Boards Coalition (www.nursesonboardscoalition.org). Share nurses’stories about innovative solutions to local problems with the media or write a letter to the editor. Start an interdisciplinary innovative solution team to resolve problems within your workplace or your local community. Advocate for a national nursing leadership position such as a senior nurse in the government. Support nurses in government leadership roles at all levels.

SDG 5: GENDER EQUALITY

SDG 5 calls for an end to all forms of gender discrimination toward women and girls.³ Gender inequality reduces chances for educational and economic independence, thus impacting health, decreasing life span, and damaging well-being. Promoting women’s economic development has been shown to improve not only women’s economic standing, but also the overall economic development of countries and businesses.^4,5 By promoting SDG 5, nurses can help women achieve better health and societies to foster greater gender equality and stronger economies.⁶

One of many ways gender inequality manifests is through physical or sexual intimate partner violence (IPV). Globally, one in three women has experienced physical or sexual IPV in her lifetime.⁷ The COVID-19 pandemic, which has caused victims to be locked in with their abusers and become isolated from resources, has triggered an alarming upsurge in IPV, creating a “shadow pandemic.” The exact increase is difficult to quantify because many cases of IPV go unreported, but cursory numbers show a rise of reported cases of up to 30% in some countries.⁸ This is a critical time for action. Nurses can help reduce IPV through such actions as advocating for enhanced screening in their practice setting.

Discriminatory policies in the workforce are another manifestation of gender inequality. For example, while women make up 90% of the nursing workforce globally, they occupy only 25% of health leadership positions and are paid less than men.⁹ As nursing is a predominantly female occupation, nurses are in a unique position to promote gender equality by supporting their colleagues in achieving leadership positions and equal pay.

Sigma aims to educate and empower individuals and communities to actualize gender equality at such UN events as the annual session of the Commission on the Status of Women, presenting on topics ranging from decreasing violence against women to promoting nurses in leadership and policy roles.^10,11 These presentations bring together like-minded professionals from all walks of life, encouraging collaboration, networking, advocacy, and mentorship.

The ultimate vision of the 17 SDGs is one of social justice and inclusion for all people everywhere. To this end, nurses must be advocates for all human beings throughout the gender identity spectrum to achieve targets 5.1 (end all forms of discrimination against all women and girls everywhere) and 5.2 (eliminate all forms of violence against all women and girls).³ Globally, health inequities and discrimination are associated with lesbian, gay, bisexual, transgender, and queer/questioning-identified (LGBTQ+) persons experiencing disproportionately poorer health outcomes, higher suicide and substance abuse rates, and more violence than their heterosexual and/or cisgender counterparts.^12,13 While not explicitly mentioned in the SDG 5 targets, it should be recognized that harmful sexual and gender stereotypes may lead to self-limiting behaviors (for example, not disclosing sexual or gender identity), as well as gender-based violence directed toward LGBTQ+ persons.¹⁴

SDG 8: DECENT WORK AND ECONOMIC GROWTH

The aim of SDG 8 is to promote decent work opportunities and sustained economic growth, particularly in the most vulnerable, low income countries.³ Growing the nursing workforce locally and globally contributes to SDG 8 by providing pathways for economic empowerment through nursing education and career opportunities.

The COVID-19 pandemic revealed weaknesses of public health systems, especially a shortage of health care workers and resources such as personal protective equipment.^15-17 At 27.9 million, nurses are the largest group of health care professionals worldwide.⁹ Yet despite the recent growth in their overall numbers, an increase of 8% in new nursing graduates is needed globally to address the projected nursing shortage.⁹ Investments in health employment can move countries closer to universal health coverage, improve economies, and protect countries against outbreaks such as COVID-19.¹⁸

In a joint statement with the International Council of Nurses, Sigma celebrated International Women’s Day 2020 by recognizing the contributions of the nursing profession to economic prosperity and a healthier world.¹⁹ Nurses can advance the profession through everyday activities such as mentoring students and new graduates, promoting positive work environments, increasing professional visibility through social media, and investing in continuing education and career progression. In addition, they can raise the profession’s collective voice and influence policy change at all levels—within their organizations as well as regionally, nationally, and internationally—by voting in local and national elections and joining and actively participating in professional organizations such as Sigma.

SDG 17: PARTNERSHIPS FOR THE GOALS

Innovative partnerships among organizations, professions, sectors, and countries have the potential, through collective action, to better achieve all the UN SDG goals.³ Collaboration across organizations maximizes the utilization of resources, allowing for an impact that can be far more significant than that of a lone organization.

Nurses at every level can create community partnerships to promote health and influence policies and legislation. And with increasing public awareness of the critical role they have been playing during the COVID-19 pandemic, nurses now have the added power of media attention and can use this platform to offer innovative solutions to local problems, educate the public, help improve health care systems, and address workforce challenges. In addition, by sharing their stories on social media, they can bring attention to their expertise and further raise awareness of their valuable contributions to their communities.

The Sigma UN representative team aims to make nurses visible as expert resources to improve global health. For example, at the 2019 High-Level Political Forum, Sigma delivered an oral statement to ECOSOC to highlight the essential role of nurses in promoting population health. Emphasizing the importance of government support of the nursing workforce to improve recruitment and retention, Sigma called for increased investment in nursing education, improved practice environments, and decent working conditions and pay. Sigma members have also presented at workshops and briefings, drafted collaborative summative outcome documents that have led to UN resolutions, and provided interventions related to the SDGs in the UN system.

By developing mutually beneficial partnerships across professions and organizations, Sigma has been demonstrating the value of nurses in formulating health care policy at the highest levels of government. Partnerships and collaborations with the World Health Organization, the International Council of Nurses, Jhpiego, Johnson and Johnson, the International Federation on Ageing, the UN International Children’s Emergency Fund (UNICEF), the Transcultural Nursing Society, and the Commission on the Status of Women have positioned nurses as catalysts for change, increasing the likelihood of developing interventions that are meaningful and long lasting.

Finally, the Sigma representatives to the UN also share their experiences and expertise with Sigma members internally, at live events, and through personal communication. This work inspires and incentivizes local Sigma chapters to provide programming and share information on the work of the UN, the SDGs, and the impact of nursing at the global level.

CONCLUSION

The SDGs provide the theoretical premise and the practical pathways to achieve a world of equity and social justice where no one is left behind. Concrete plans that translate the goals into local, measurable, and sustained action in a given practice setting are critical. Sigma’s advocacy at the UN is a prime exemplar of the type of long-term partnership and increased profile and visibility of nurses that will help heal the world in the wake of COVID-19 and redefine nursing for future generations. As members of Sigma’s Global Advisory Panel on the Future of Nursing and Midwifery have urged, “Let us all work toward the dream of building nursing into the global force that will strengthen health systems and provide health care for all on the planet.”²⁰ Through perseverance and strategic goal setting, we can do just that.