COVID-19 is one of the most significant challenges for generations.  The pandemic has impacted every individual across the globe. Its enormity can be felt in the shocking number of deaths, financial losses, rising unemployment, food insecurity, and the increasing number of households falling below the poverty line—worsening inequities across communities. The pandemic however is also exacerbating and layering onto already unacceptable preexisting, persistent burdens of maternal mortality, HIV, tuberculosis, malaria, and noncommunicable diseases. It has resulted in disruptions to essential health services and significant setbacks to gains made in antiretroviral therapy,  immunization programs, infant mortality reduction, and gender equity. 

Although COVID-19 presents numerous profound challenges, it also provides a remarkable opportunity for the global community to refocus on the importance of building strong and resilient health systems, powered by a robust and well-resourced health workforce. Both are essential to surmounting the great health challenges of our time and achieving Universal Health Coverage (UHC). For Seed, the urgency of the moment requires leaning into crisis and collaborating with our partners to find new ways to strengthen the health workforce where they are needed the most. 

Globally, Seed has focused on public awareness of the importance of health, as well as, convening, and online training to adequately support health workers. We engaged in advocacy activities to ensure that policies of our partner countries, the US Government, and multilateral agencies are centered on both the pandemic response, as well as, essential ongoing capacity building within health systems. Recognizing the gaps in specialized training materials and guidelines, Seed launched the COVID Content Hub, a community-sourced knowledge resource for partners, health workers, and governments. The hub simplified the dissemination of urgently needed key resources and made each easy to access, download, and share. 

Seed’s work in our partner countries over the past years has been fundamental and critical to addressing health challenges of all types. It also helped position us to rapidly map and assist in their COVID-19 preparedness and response. Seed partnered with key training and clinical institutions and Ministries of Health in Malawi, Sierra Leone, Uganda, and Zambia to protect frontline health workers, maintain essential health services, and build long-term health systems capacity. Through these partnerships, we held a series of technical briefings that covered topics ranging from maintenance of midwifery care for COVID-19 positive mothers to considerations for building isolation centers. To safeguard the health and safety of health workers, we donated personal protective equipment.

Across the four countries, Seed sought innovative ways to minimize disruptions to essential care, in collaboration with our partners. Our staff served on national COVID-19 response task forces, focusing on priority areas most closely aligned with our technical expertise and the urgent needs of our partner institutions. Seed Educators continued to support their students and colleagues remotely. They were engaged in lecture development, course creation, teaching, helping rotating interns with patient management, simulation lab support, and mentorship. The educators also contributed to national case management guidelines and clinical site preparation for maintaining essential health services during the pandemic. 

2020 was declared as the International Year of the Nurse and the Midwife by the World Health Organization. In support of the year, Seed led a coalition of global health organizations to raise the profile and needs of these essential health workers through a global advocacy and awareness campaign, Nurses Lead | Midwives Lead. Through the coalition and campaign, we highlighted nurses and midwives for their fundamental contribution as responsive and respected experts, leaders, navigators, innovators, advocates, and influencers. We called on governments and world leaders to increase investments in training, ensure representation and inclusion in policy making, and commit to nursing and midwifery leadership development.

Through digital media, thought leadership, and global convening, we celebrated nurses and midwives, raised awareness of their critical role in the delivery of UHC and the attainment of the Sustainable Development Goals, and advocated for increased investment in both professions. Through these platforms, nurses and midwives outlined, in their own powerful words, the challenges that they face, experiences providing care in the face of COVID-19, and better ways in which the global health community can support them. They addressed topics ranging from maintaining essential services during times of health crises to decolonizing global health. Most importantly, the campaign created an enabling environment for nurses and midwives to demand better representation and recognition in global and national health policymaking.

In May 2020, Seed published a special collection of Annals of Global Health, a peer reviewed journal aimed at advancing and disseminating global health knowledge. Titled 2020 Year of the Nurse Midwife: Passion, Power, and Purpose. The collection shared the passion of nurses and midwives for their profession, the power of their convictions, and their purpose in bringing comfort and health to their patients and communities. 

Across our partner countries, we collaborated with the ministries of health, professional associations, and others to celebrate nurses and midwives for their extraordinary contributions to health delivery. Together, we advocated for increased support for both cadres to enable them to effectively respond to COVID-19 while protecting their safety and wellbeing. Additionally, Seed leveraged media partnerships to raise public awareness on critical investments needed in nursing and midwifery education, practice, and policy in order to improve health outcomes and ensure access to lifesaving care. 

In Uganda, Seed supported the creation of the Nurses and Midwives Think Tank. The forum brought together nurses and midwives from across the country to advocate for their professions and contribute to the national COVID-19 response. Through targeted webinars hosted by the think tank, nurses and midwives got training on topics ranging from leadership to mental health, preparing them to address the ongoing pandemic and effectively tackle future crises. To further support health workers on the frontlines, the think tank fundraised to procure PPE for their colleagues in three major hospitals that have COVID-19 treatment units.

The COVID-19 pandemic and 2020 underscored the importance of our frontline health workforce. Their training, knowledge, and skills are powerful foils against the ever increasing and frequent health threats we face today. 

COVID-19 has also shown – and exacerbated – long standing inequities that have been festering for years. The global movement for racial justice in 2020 catalyzed the beginnings of much-needed conversations on reckoning on the history of painful policies and practices in the U.S. and beyond that have resulted in suppression, structural violence, death, and health disparities among Black, Indigenous, and people of color. Through our work, we have experienced these inequities globally and seen how countries with whom we partner have been crippled by colonialism, racism, and power structures that create a cycle of dependency and struggle.

Seed has been and remains deeply committed to changing this dynamic. We are implementing new organizational systems to make sure that our practices align with our values and every voice is celebrated, respected, and thrives. We continue to educate ourselves and proactively find ways to be a part of the solution and agents of positive and necessary change in the U.S. and globally. As a part of the global health community, we collaborate closely with our partner countries to ensure that the people with whom we work are the custodians of their own power.

2020 displayed the stakes we face but also offers us a historic opportunity to examine our lived values. We can be challenged—in the best of ways—to consider what we believe in and how we enact those beliefs. We have to confront—including in global health—the deleterious systems we perpetuate. We can shape a bigger and meaningful conversation about the society we should create so that everyone can thrive. We can value wellbeing, dignity, and true equity for all and we can share the power, voice, and priorities essential to finally close the inequity gaps that have persisted globally for years.

At Seed, we believe that collectively, we can define a strong legacy of this moment. We can leverage this chaos to reset and be powerful forces for good. We have an opportunity to redesign and create a more just and healthy society by making lasting investments that will span generations. Together, we can challenge the status quo.