A global comparison of nursing and midwifery's and medical efficacy in preventing COVID-19 deaths 2019-2022

Aim: Compare roles of nurses and midwives and physicians in reducing COVID-19 deaths measured with a case fatality ratio.

Background: The roles and responsibilities of different health disciplines to the COVID-19 pandemic vary. While more difficult to measure, objective assessments of discipline contributions of nurses and midwives and physicians can be viewed through statistical analysis.

Methods: Population-level data are analysed with scatter plots, bivariate correlations, partial correlation and multiple linear regression models to illustrate the contributions of nurses and midwives and physicians in reducing COVID-19 deaths. The role of nurses and midwives and physicians in protecting the community against COVID-19 deaths is explored and compared using competing effects of affluence, age and urbanization. Data analysis software programs include Excel v.2016, SPSS v.28 and Fisher r-to-z transformation.

Results: Nurses and midwives reduce COVID-19 deaths significantly more than physicians. This difference remains while controlling for physician care, economic affluence, median age and urbanization individually or in combination. In contrast, the role of physicians in reducing COVID-19 deaths is less independent than nurses and midwives. Linear regression results insinuate when nursing and physician care are collated together with other predicting factors, physicians' contribution to community protection against COVID-19 case fatality ratio is statistically explained by nursing and midwifery care.

Discussion: Unlike physicians, the nursing and midwifery workforce is bigger and located throughout all healthcare system levels and, therefore, is more accessible to the community. This is an important point in explaining the contribution of nurses and midwives to reducing COVID-19 deaths when compared with physicians.

Conclusion: This study suggests that, worldwide, the nursing and midwifery workforce may play a more significant role in protecting the community against COVID-19 deaths than physicians.

Implications for health policy, nursing and midwifery practice: The findings from this study offer a unique perspective for health authorities to further understand the complementary and independent role of the nursing and midwifery workforce in respect of the healthcare team. This study suggests the importance of a broader range of healthcare services, especially during the pandemic, for example, COVID-19. With the permission of health authorities, the nursing and midwifery workforce should have further extension of their scope of practice in situations such as pandemics due to their broader access to the community.