The National Institute of Nursing Research (NINR): Nursing research and training spur global health gains

by Cathy Kristiansen

No profession is more integral and essential within every level of global health care than nursing. Because of their close relationship with patients, nurses are ideally positioned to design and drive scientific discoveries that can be implemented directly into clinical practice. Since 1986, the NIH's National Institute of Nursing Research (NINR) has been supporting critical investigations to advance disease prevention, patient self-management, end-of-life care and treatment innovations, as well as funding training for nurse scientists.

The results of nursing research help build the knowledge base and provide the evidence to guide interventions by nurses and other health care workers. From studying approaches to prevent HIV/AIDS in Jamaican girls, to assessing water filters that could reduce cholera outbreaks in Bangladesh, or identifying how to lessen depression caused by HIV/AIDS, NINR-funded nurse investigators are producing scientific evidence that improves health around the globe.

These advances are particularly important for developing countries, where doctors are scarce and there are many hard-to-reach and underserved populations. Nurses and nurse scientists help fill the gaps, including training essential health care workers. Developing expertise in low-resource settings has never been more critical, since diseases such as Ebola can quickly move from a child in a West African jungle to a nurse in Texas.

"In an increasingly interconnected and mobile world, global health threats such as tuberculosis, SARS, Ebola and influenza, among others, can spread at the speed of a jet plane," NINR Director, Dr. Patricia A. Grady, commented. "Nursing science is at the forefront of designing programs that promote wellness, prevention and, not coincidentally, lower health care costs."

Rapid advances in technology and genomic science, as well as significant changes in demographics and health care policies and practice, have placed new demands and created opportunities for nursing to find fresh approaches and interventions to improve health. With the increasing prevalence of mobile phones in even the poorest countries, there are new avenues to develop technological tools, such as the lab-on-a-chip (see the related article Lab-on-a-chip provides speedy disease diagnoses ), and find innovative ways to communicate health information.

NINR has supported studies in more than a dozen developing countries over the past decade in such critical areas as reducing maternal and infant deaths related to childbirth, studying text messaging to improve patient drug adherence to combat tuberculosis, and finding more effective methods to limit the spread of HIV/AIDS. More recently, NINR has begun to address the rising tide of noncommunicable diseases by supporting the development of the research expertise needed among nurses in Thailand and elsewhere.

NINR also invests in global health research training for early-career nurse investigators, in collaboration with Fogarty. For instance, the agency has supported participants in Fogarty's Global Health Program for Fellows and Scholars, which has provided mentored training in HIV/AIDS, tuberculosis and tropical disease research for nurses working in countries such as Argentina, Thailand, Malaysia and India. (See the related article Fogarty nursing fellow oversees HIV trials in India .)

The seeds of NINR-funded global research are spreading as researchers share discoveries and other developing countries recognize the value of these more effective and economical interventions. For instance, in a South-South collaboration, researchers in Chile are building on an NINR-supported model developed in Botswana and Malawi to mobilize health care workers to drive HIV/AIDS prevention patient education.

In these and similar projects around the world, NINR is working to identify areas in need of research, disseminate scientific findings and form global partnerships to improve the health and well-being of all the world's citizens.