The Public Health Nursing Series is a 20-blog collection, written by William (Billy) Rosa, author of the forthcoming title, Nurses as Leaders: Evolutionary Visions of Leadership (June 2016), that sparks a dialogue about each and every nurse's role in advancing and creating the future of global health. With a focus on cultural considerations and the current status of healthcare in nations worldwide, nurses will learn how they are called to contribute to each of the United Nations' 17 Sustainable Development Goals, an international initiative that seeks to end poverty, protect the planet, and ensure prosperity for all over the next 15 years.This series makes the case that every nurse, regardless of title, position, or credential, is a public health leader.

Global Citizenship in the Wake of the Millennium Development Goals (Part 3)

Our work as public health leaders calls us to engage with populations and communities across nations and continents. It requires us to develop an understanding of others as interconnected to our shared humanity and to value health care as a human right. Public health, and global health in particular, asks us to examine what and how we are leading. It beckons us to reflect and hone in on what exactly we are striving for: Are we aiming for others to experience health and vitality as we understand it or are we genuinely interested in their experience of wellbeing from their perspective? Do we lead initiatives based on morals from our worldview or do we accept that ethical considerations adjust according to the cultural paradigms, norms, and value systems in which we find ourselves? It is about allowing ourselves to evolve past self-limiting definitions and embrace partnerships that nurture health and wellness for all involved.

Global health is about context and relationship. The bottom line is that all behaviors make sense in context. Public health nurses play a key role in implementing programs that create and sustain access to quality care throughout the global village (Nicholas & Breaky, 2015). In order to fulfill this role, there must be a willingness to integrate context into how care is both conceived and delivered. The globalization of health care is a daily reminder that there is no one way of doing things, no right way to address disparities, and no correct approach to any problem. There is only context, communication, compromise, and collaboration. We must look to embrace concepts such as flexibility, understanding, empathy, patience, and cultivate the skill of deep listening. The lens we are privileged to have as public health nurses gives us the opportunity to see the human story behind the data; the individual implications beneath the collective circumstances. If we are able to nurture collaborative partnerships rooted in bidirectional communication and mutual understanding, the goal of compassionate and culturally sensitive health care becomes possible (Benjamin, 2012).

A good question to ask might be: How do I define myself? Is it by my profession, my ethnicity, or religion? Do I limit myself as a “man” or a “woman,” as a “PhD” or “MPH”? It is helpful to remember that with labels come limitations and with categories come classifications that prevent authentic and culturally humble interactions. If a definition is needed to help give direction and footing to your work as a public health leader, try this on… I am a global citizen. Hugh Evans, cofounder of Global Citizen (2012-2016), an international community striving to end extreme poverty and inequality worldwide, defines a global citizen as “someone who identifies first and foremost not as a member of a state, tribe or nation, but instead as a member of the human race,” and he emphasizes that “[w]hen you make global citizenship your mission you suddenly find yourself with extraordinary allies” (Evans, 2016). And who among us doesn’t need more allies in the processes of context and relationship?

As a global citizen, we must know where the communities we serve have been so that we might be of value in getting them where they are going. The most well-known and unprecedented cross-cultural initiatives were born out of the 2000 United Nations (UN) Millennium Summit and are known as the Millennium Development Goals (MDGs; UN Millennium Project, 2006). The MDGs were designed as a 15-year plan to accomplish the following:

  • Goal 1: Eradicate Extreme Hunger and Poverty
  • Goal 2: Achieve Universal Primary Education
  • Goal 3: Promote Gender Equality and Empower Women
  • Goal 4: Reduce Child Mortality
  • Goal 5: Improve Maternal Health
  • Goal 6: Combat HIV/AIDS, Malaria, and other diseases
  • Goal 7: Ensure Environmental Sustainability
  • Goal 8: Develop a Global Partnership for Development

While public health nurse leaders have played key roles in furthering Goals 4, 5, and 6 (Beck, 2016; Nightingale Initiative for Global Health [NIGH], 2016), I would argue that we have influenced each of them as we’ve continued to promote and procure worldwide physical, mental, social, economic, and environmental health for all.

The 2015 Millennium Development Goals Report demonstrates that the collaborative efforts implemented to realize the MDGs have saved millions of lives and exacted dramatic improvements by even the poorest of countries (UN, 2015). However, there is much more work to be done. With the adoption of the Sustainable Development Goals (SDGs) by world leaders, nations across the globe will collaborate over the next 15 years to “build on the success of the MDGs… end all forms of poverty, fight inequalities and tackle climate change, while ensuring that no one is left behind” (UN Sustainable Development, 2016).

Enter the public health nurse leader.

Enter – you.


Beck, D.M. (2016). Artistic and Scientific: Broadening the Scope of our 21st Century Advocacy.

In W. Rosa (Ed.), Nurses as Leaders: Evolutionary Visions of Leadership. New York, NY: Springer, in press.

Benjamin, B.A. (2012). Building relationships and engaging communities through collaboration. In A.L.C. Curley & P.A. Vitale, Population-based nursing: Concepts and competencies for advanced practice (pp. 211-238). New York, NY: Springer.

Evans, H. (2016). What does it mean to be a citizen of the world? Retrieved from            d?language=en

Global Citizen. (2012-2016). Who we are. Retrieved from

Nicholas, P.K. & Breakey, S. (2015). Global health and global nursing. In S. Breakey, I.B.      Corless, N.L. Meedzan, & P.K. Nicholas (Eds.), Global Health Nursing in the 21st Century, (pp. 3-24). New York, NY: Springer.

Nightingale Initiative for Global Health (NIGH). (2016). Raising awareness for mothers’ health. Retrieved from

United Nations (UN). (2015). The Millennium Development Goals report: 2015. Retrieved from       (July%201).pdf

United Nations (UN) Millennium Project. (2006). What they are. Retrieved from   

United Nations (UN) Sustainable Development. (2016). The Sustainable Development Agenda. Retrieved from

More About the Author

William (Billy) Rosa, MS, RN, LMT, AHN-BC, AGPCNP-BC, CCRN-CMC, is currently Visiting Faculty, University of Rwanda and ICU Clinical Educator, Rwanda Military Hospital, Human Resources for Health Program in partnership with the New York University Rory Meyers College of Nursing. He currently has over 65 publications for refereed and non-refereed journals, newspapers, magazines, and national platform blogs and his book, Nurses as Leaders: Evolutionary Visions of Leadership, will be released by Springer in June 2016. Billy currently sits on the US Advisory Board for the Nightingale Initiative for Global Health, and most recently received the American Association of Critical-Care Nurses' 2015 National Circle of Excellence Award and the Association for Nursing Professional Development's 2015 National Change Agent/Team Member Award.

Quick Links

Part 1 -  Understanding the Nurse as a Public Health Leader

Part 4 - Sustainable Development Goal #1 - No Poverty