article · Dove Medical Press (Taylor and Francis Group)
Emmanuel Ndahiro Manirafasha, Helen Ewing, Augustine Ndaimani, Ngwibete Atenchong, Daniel M Maweu, Catherine Uwimana Center for Nursing and Midwifery, University of Global Health Equity, Kigali, RwandaCorrespondence: Emmanuel Ndahiro Manirafasha, Center for Nursing and Midwifery, University of Global Health Equity, Kigali, Rwanda, Email emmyndahiro14@gmail.comAbstract: The World Health Organization (WHO) estimates that there are approximately 29.8 million nurses worldwide, making nursing the largest professional group within the health sector and accounting for nearly 60% of the global health workforce. Nurses play a critical role in delivering quality care, promoting health, and strengthening health systems. Despite their essential contributions, nurses remain underrepresented in health policy formulation and decision-making processes across many healthcare settings. Although the existing literature recognizes the importance of nursing leadership, limited attention has been given to the structural and professional barriers that continue to restrict nursesâ active participation in health policy development, particularly in low- and middle-income countries (LMICs). This perspective article examines the importance of nurse participation in health policy development and implementation by drawing on global evidence and selected examples from low- and middle-income countries. The article discusses how nursesâ close engagement with patients, communities, and frontline healthcare services provides unique insights into healthcare realities that are essential for designing effective, patient-centered, and contextually relevant policies. It further highlights key barriers to nursesâ involvement in policy processes and outlines strategies to strengthen their leadership capacity and policy engagement. The paper calls for deliberate efforts to build nursesâ leadership and policy competencies, establish clear pathways for participation in decision-making, and institutionalize nursing representation within policy forums. Enabling nurses to transition from the bedside to the policy table is not only about professional recognition but also a strategic step toward building more responsive, inclusive, and sustainable healthcare systems.Keywords: nursing leadership, health policy, policy development, health systems
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