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As part of efforts to achieve the health targets in the Millennium Development Goals, health ministers from Member States throughout the WHO European Region met in Munich, Germany in 2000 to focus on nurses’ and midwives’ important role in health development and health service delivery. In the resulting Munich Declaration, the ministers pledged to strengthen nursing and midwifery in their countries. They also asked WHO/Europe to provide strategic guidance for this process and to monitor and evaluate its progress.

WHO/Europe fulfils this mandate by working to improve the education, professional opportunities and influence of nurses and midwives in the European Region. It has made regular progress reviews of implementation of the Munich Declaration in the 53 Member States; evidence from these reviews assists Member States in determining the actions needed to further strengthen nursing and midwifery.

Recommended actions may include:

• raising nursing and midwifery education to the university level;
• expanding the scope of nursing and midwifery practice;
• preparing nurses for leadership roles in the health care system;
• creating pathways for career progression;
• improving the working conditions and salaries of nurses and midwives;
• increasing nurses’ and midwives’ participation in decision-making at all levels of policy development and implementation;
• developing effective workforce planning strategies;
• measuring the quality of nursing and midwifery services;
• raising awareness in government and society of the importance of nurses’ and midwives’ work.