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.

Sustainable Development Goal #4: Quality Education (Part 7)

Nursing’s role in educating the public has forever been a cornerstone of the profession. It is a nursing prerogative to procure quality education for those we serve and deliver it a meaningful context for the client.  But how do we know our education is effective? How do nurses assure that education is given in a way clients, be they individuals or populations, can receive it? What is nursing’s duty in promoting equitable educational access on a global scale? Quality education delivery as a human right is one of the changes needed to transform the world as we know it; and public health nurses have an essential part to play.

Sustainable Development Goal (SDG) #4 seeks to “ensure inclusive and quality education for all and promote lifelong learning” (United Nations Sustainable Development [UNSD], 2016). Quality education is vital in order to change people’s lives from the root level and aid human beings to rise beyond the economic opportunity limitations inherent in poverty-stricken countries. Of the 103 million youth lacking basic literacy skills, 60 % of them are women, 57 million children remain unable to attend school in developing nations, and roughly 50% of primary school age children currently not enrolled in school live in conflict affected areas (UNSD, 2016). Without appropriate educational training, young people in low-income and resource-constrained settings are limited in their abilities to create a healthier and safer life for themselves and their families.

According to UNSD (2016), some of the targets of SDG #4 include a commitment to realize the following by 2030:

  • Ensure that all girls and boys complete free, equitable, and quality primary and secondary education
  • Ensure that all girls and boys have access to quality early childhood development, care, and preprimary education
  • Ensure equal access for all women and men to affordable and quality technical, vocational, and tertiary education, including university
  • Substantially increase the number of youth and adults with relevant skills for decent jobs and entrepreneurship opportunities
  • Eliminate gender disparities in education
  • Ensure all youth and substantial number of adults achieve literacy and numeracy
  • Increase the global supply of qualified teachers

Public health nurses contribute to education equity by working with in-country affiliates to improve healthcare professional training and preparation. For example, organizations such as SEED Global Health “strive to strengthen health education… in places facing a dire shortage of health professionals by working with partner countries to meet their long-term health care human resource needs” (2016). SEED is currently working in Malawi, Tanzania, and Uganda and will be launching new programs in Liberia and Swaziland later in 2016. The provision of high quality education for nurses brings with it the promise of safer healthcare services and increased health systems for populations at large.

There are substantial challenges to increasing the quality of nursing education in low-income countries, and therefore, the health education of the public in those countries. In Egypt, though master’s and doctoral degrees in nursing are possible, secondary school training and associate degrees are the norm, with bachelor’s degrees requiring more money and time for students who may not have the means (Elcokany & Hussein, 2014). Obstacles such as the unequal distribution of nurses throughout Egypt, improper role delineation, long working hours, poor working conditions, and low wages significantly hinder nursing advancement. Public health advocacy and the ability of nurses to build partnerships at the policy and regulatory levels are integral to overcoming these barriers.

As we combine efforts to ensure that SDG #4 is achieved by 2030, we must begin to develop a new understanding of what education means to those living in low-income contexts and cultures different from our own. The systems they hope to build may not look like those in developed nations. Their educational aspirations will undoubtedly include alignment with the broader sociopolitical goals of the nation and take significant resource constraints into consideration. Never has a true understanding of collaboration been so necessary:

Collaboration is the creation of a synergistic alliance that honors and utilizes each person’s contribution in order to create collective wisdom and collective action. Collaboration is not synonymous with co-operation, partnership, participation or compromise. Those words do not convey the fundamental importance of being in relationship nor the depth of caring that is collaboration. Collaborators are committed to, care about and trust in each other. They recognize that despite their differences, each has unique and valuable knowledge, perspectives and experiences to contribute to the collaboration (Hills, 1992, p. 14; Hills, 2016; Hills & Watson, 2011, p.71).

The programs and initiatives that will be implemented to carry out the goal of quality education for all and an environment of lifelong learning will require patience, flexibility, openness, cultural humility, and a commitment to collaboration in order to create meaningful change for those we serve.


Elcokany, N. & Hussein, A. (2014). Seeking higher education: From Egypt to the United States. In M.J. Upvall & J.M. Leffers (Eds.), Global health nursing: Building and sustaining partnerships (pp. 34-44). New York, NY: Springer.

Hills, M. (1992). Collaborative Nursing Project. Development of generic integrated nursing curriculum in collaboration with four partner colleges. Report to Ministry of Advanced Education, Centre for Curriculum and Professional Development.

Hills, M. (2016). Emancipatory and collaborative: Learning to lead from beside. In W. Rosa (Ed.), Nurses as leaders: Evolutionary visions of leadership. New York, NY: Springer, in     press.

Hills, M. & Watson, J. (2011). Creating a caring science curriculum: an emancipatory pedagogy for nursing. New York, NY: Springer.

SEED Global Health. (2016). About SEED Global Health. Retrieved from

United Nations Sustainable Development (UNSD). (2016). Goal 4: Ensure inclusive and quality education for all and promote lifelong learning. 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.

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Part 1 -  Understanding the Nurse as a Public Health Leader

Part 8 - Sustainable Development Goal #5 - Gender Equality