Diaspora Consortium Report 2024

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THE DIASPORA NURSING AND MIDWIFERY 1 ORGANISATIONS (DNMO)

ACKNOWLEDGEMENT AND CONTRIBUTORS I am grateful to all the participants who represented their organizations and completed the activity.

I would also like to thank the following colleagues for their input in sharing discussion points and reviewing the draft report: Winnie Gasana, Charmaine Case, Dr Felicia Kwaku OBE, Sally Nyinza and Jesca Gudza.

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CONTENTS Background ………………………………………………………………………………….. 2 Introduction ………………………………………………………………………………….. 2 The study ……………………………………………………………………………………….. 3 Results …………………………………………………………………………………….…….. 5 Discussion ………………………………………………….…………………………………… 10 Conclusion and recommendations …………………………………………….... 13 Disclaimer …………………………………………………………………………………….. 14 References ……………………………………………………………………………………… 15 Appendix A Inventory list of UK diaspora nursing and midwifery organizations ………………………………………….…………………………….…….………..16 B Table showing nationality representation in the NHS, 2023 ……………………………………………………………………………….……….…….……… 17 C Table showing diaspora engagement offices from origin/birth countries ………………………………………………………………………………………………..18         

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BACKGROUND According to the study of etymology, the term "diaspora" is derived from the ancient Greek verb diaspeirō, meaning "I scatter" or "I spread about". This report refers to the diaspora as ethnic Health Care Professionals (HCPs) who have migrated and are now residing and working in the United Kingdom (UK) as a host/residence country but maintaining strong links with their countries of origin/birth (THET, 2021).

As of 2019, over 215 million people live outside their countries of origin/birth. The largest is the Indian diaspora estimated to be over 17.5 million, across the world (Canton, 2021). Having completed my research study on the role of the Diaspora Health Organizations in the recruitment, retention, and integration of Black Asian Minority Ethnic (BAME) HCPs in the UK; as part of fulfillment for a master’s course, there was a gap identified and the need to present a brief analysis of who the Diaspora Nursing and Midwifery Organizations comprise of. This report provides evidence of some of the profiles, functions, and contributions of the Diaspora Nursing and Midwifery Organizations.

INTRODUCTION Roughly a quarter of the over 1.3 million National Health Service (NHS) employees are individuals of BAME background (Office of National Statistics (ONS). In March 2019, the NHS reported that 79.2% of its staff was White, and 20.7% identified as belonging to the BAME communities. Of these, 40% were medical doctors, and 20% were in the nursing workforce (Chaudhry, 2020). During the pandemic, many BAME HCPs formed these organizations; including the Uganda Nurses and Midwives

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Association UK (UNMA-UK) which the presenter of this report co-founded at the back end of the second wave of the pandemic in 2020; and the most recent in March 2022. Using a survey to amplify the functions, roles, and backgrounds of the organizations,

this

report

presents

the

findings

that

demonstrate

their

contributions and achievements.

THE STUDY Despite the overwhelming contribution of remittances as foreign exchange, diaspora HCPs present as unique contributors to enhancing healthcare systems (THET, 2021). However, anecdotal reports indicate that they remain an underutilized resource in clinical systems and procedure policy formations (Ezaonwu, 2021).

The study aimed to ascertain bite-sized information about the organizations, showcase their value, and understand their levels of engagement as stakeholders in capacity building for healthcare systems with the Objective would inform the stakeholders about their nature and functions.

Method / Methodology A cursory literature review was performed during the master’s research program study. At two separate points in time, two separate searches of the Cochrane database were conducted. The methodology used for the survey was in four parts.

I. Identification of the participants - The targets of the study were leaders of known organizations who can provide a deeper understanding of the topic at hand and be able to compile reliable and precise findings that will form the analysis and

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investigation. The leaders of the known BAME Nursing and Midwifery organizations created

and

joined

a

WhatsApp

group

messenger.

Based

on

Adeoye,

(2023) discussion of important informants; a random sample of interviews was not applicable.

II. Purpose of the study - The study initiative was discussed in the group and the gap to showcase the organizations, their functions, and value was identified.

III. Data collection - Participation was strictly confidential; no personal information was collected, and the data was coded so that no information could be directly connected to the participants. The survey was conducted in 2023 over three months (March – June). The research methodology that was utilized to collect primary data was a questionnaire because primary data is widely regarded as the superior kind of data and is suitable for the investigation. The leaders were invited to review and co-design the online survey questionnaire that included qualitative semi-structured questions with a total of 8 items about their organization, and the data was collected with the use of the software known as Google Forms. The results produced both quantitative and qualitative data.

IV. Application - The survey as well as a combination of previously collected data were utilized so that the findings could be analyzed and the research methodology replicated.

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RESULTS The results have been presented in order following study and includes the nature of the organizations, the functions, objectives, and the contributions.

Out of Thirty-Two organizations represented in the group, eighteen leaders of the organizations completed the questionnaire activity, indicating that the majority are based in England, 44.4% of them are based in London, and 11.1% in Sheffield (See disclaimer page 14). The organizations vary in years of operation, the oldest having launched in 1978. The list of known organizations appears in Appendix A. Nearly half of the organizations that completed the questionnaire reported having over 300 members.

Of those that completed the activity, eight of the leaders reported being registered as Community Interest Companies (CIC), four as limited companies, three as Community Interest Organizations (CIO), and the rest indicated that they are in the process of registration.

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On the question regarding the objectives, and activities, the majority of the DNMO scored highest in the five areas below. They are in no order of priority.

1. To create a supportive professional group to belong to, including social belonging, and especially the intention to support new IR colleagues and to support them to settle and integrate, feel welcome and make successful employment stay.

2. As grass root organizations, to disseminate information into the communities.

3. To provide and participate in improved and culturally competent health care.

4. For networking opportunities and resources to facilitate the exchange of information.

5. Mentorship, and coaching for career development.

Nearly all the participants who completed the activity indicated the main area of growth and development to be funding - 94.1%. This was followed by both 6

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membership and stakeholder engagement scoring at 88.2% and leadership and proposal writing at both 64.7%. See graph below.

About 80% of those that participated indicated that they have projects and/or initiatives they organize and participate in their country of origin/birth and in the UK as the country of residence. These have been themed and categorized and the statements have been quoted and included in the table below: Theme

Quotes from the questionnaire on Projects/initiatives A) Country of origin/Birth

Education and training

Teaching in some of our nursing schools, providing material support to some of our hospitals and offering financial assistance to some UK charity organizations Resilience training/cultural integration Health and well-being, Health Education. Clinical practice NHS international diaspora project

Clinical practice

Patient care and support through various Healthcare institutional services Clinical skills support, mentor-ship, coaching, financial support to student nurses. Support to teachers and lecturers in nursing schools.

Cancer care, mental health & supporting Midwives.

Cyclone initiatives

Cyclone initiatives

Infrastructure/ supporting

We are rebuilding our hospitals by Donating equipment from some NHS hospitals.

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health care systems

Working closely with our UK community to support continued education to our hospitals such as mental health sessions, learning disabilities sessions, maternity support, drug, and substance misuse.

We have renovated two wards in two hospitals, we have in the past, sent PPEs to the main teaching hospital in the city, and provided PPE in the city slum areas.

During the Ebola outbreak in 2014, we sent a team of mental health and psycho-social members to help the victims. We sent medical equipment to the burns victims when the petrol tanker exploded.

Equipment/ supporting health care systems

Sourcing healthcare equipment in the UK and shipping.

Voluntary Field work, Model ward adoption for skills exchange, PPE donation. Amnesty agreement with the regulatory body re: default annual licence fees for our members.

B) Country of residence

Stakeholder engagement

Working with the Resuscitation Council UK, Marie Curie, DKMS, Anthony Nolan and NHSBT. Baby life, Safer Beginnings , Nursing Narratives, FNF , Capital Midwife, London Mayor's initiatives, Perinatal Health Cultural Competency workshops, RCM, Sands Ellie’s Foundation - charity supporting young people.

Capital midwife health and well-being task-force. Capital midwife antiracism workforce.

NHS international diaspora Project.

Public health and community engagement

Education and training in our communities on diseases that affect BAME during the Black History Month in October.

Working with other charities to meet the demands of our community.

Community outreach projects in communities with a high proportion of BAME groups.

Engaging ethnic minorities to participate in programs that reduce equality and promote diversity.

Mental health and Food banks.

Education and training

Supporting young children settling in UK schools.

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Pastoral Care, Wellness programmes, Masterclasses, Membership Drive Pastoral for new arrival/mentoring/coaching/growing our workforce.

We have completed a pastoral booklet; Next plan is to have an association App to include mental health support.

Pastoral care and membership support.

Health Education.

Readjust life in the UK and pastoral support.

Professional development and public health support.

Providing Pastoral support to IENs, Diabetes project initiative for community health promotion, mentoring and coaching organization members etc. Working with other black and minority diaspora groups to promote equality and diversity within the NHS.

The questionnaire activity also required that organizations identify the main challenges that they are experiencing and trying to overcome. The results have been themed and the statements have been quoted and included in the table below: Theme

Statements from the questionnaire

Funding

Funding for webinars, travel, administration, etc.

Workload and funding Funding and member participation activities Opportunity to get grants or be funded for our local projects. We keep applying. We rely heavily on membership subscriptions.

Collaboration, commitment. Funding. Global community

Leadership in the organization

Internal governance Transformational leadership Commitment of Trustees due to pressure of work Lack of protected time

Member engagement

Collaboration, commitment. Funding. Global community Membership engagement Paid membership, people are not keen to make any contribution.

Getting more executive team members

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Commitment of Trustees due to pressure of work Member engagement due to work commitments Lack of protected time wide geographical differences Membership engagement and recruitment of new members Lack of engagement utilising social media Growing the membership and including younger members.

An increase in members to take up Officer posts Support for members

Members facing workplace issues including NMC referrals, Members not being progressed in their careers, discrimination, bullying and harassment, lack of professional development opportunities, lack of flexible working Lack of engagement More pastoral and professional support for our members

Support from workplace

Getting time off from work to undertake some of the meetings being held.

Pledge from Senior Teams in the NHS and Private sector for support.

Time management, we hold our jobs and the expectations to deliver at our own professional, personal and financial detriment. We are using our leave to support our members and use our personal finance money to fund professional events. lack of flexible working

Recognition and support from the country of origin

Engagement from top bands from country of origin supporting our initiatives.

Linking in with the country of origin on leadership and strategy personal and financial detriment. We are using our leave to support our members and use our personal finance money to fund professional events.

Visibility

Members engagement, utilizing social media DISCUSSION

The discussion section has been analyzed from the themes from the results of the activity. They have been grouped into sub-titles.

Geographical catchment All the eighteen organizations that completed the study indicate that they are based in England. However, the CIC and CIO register organization addresses across

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the UK. With now over thirty organizations, there is a need for a repeat study to capture more data that represents the organizations as based across the whole of the UK.

Structure and governance The organizations that completed the activity demonstrated that they are independent organizations with bespoke governance structures and report to the appropriate regulatory bodies. They indicated that they are registered entities as either CICs or CIOs and others were in the process of registration evidencing their professionalism to adhere to appropriate legislation and regulation.

Diaspora Contribution From the results presented, the organizations are innovative and evidence bridging inequality gaps identified through self-funded initiatives and contributing to invaluable work including Cyclone initiatives, outsourcing and supplying equipment, training and education, pastoral care, and the retention and integration of the BAME HCPs.

In 2023, the diaspora overwhelmingly recorded contributions to the countries of birth/origin of the foreign exchange as remittances, which was recorded to be USD 656 billion as reported by IMO, an increase of 0.7 percent. Despite this evidence of contribution, few Low Middle-Income Countries (LMIC) have set up strong, effective links with the diaspora in the host countries as evidenced in Appendix C. This means that the diaspora remains an underutilized resource in clinical systems and policy formations on procedures and more information is required to

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understand and examine their impact and contribution to enhancing the healthcare systems (THET, 2021).

Legacy and recognition As disclosed by Ezeonwu, (2021), diaspora play a role in health inequalities that require coordinated, multi-stakeholder, collaborative partnerships at both local and global levels. From the results above, the organizations have been contributing to various initiatives and projects both in the countries of residence and origin/birth; the first organization was created in 1978 with an outstanding legacy.

These play an in-depth critical role as grassroots organizations in analyzing data, disseminating it, and contributing to public health concerns including highlighting discrepancies in the UK.

With the ongoing discussions on funding shortages, retention of the BAME HCPs should be viewed as equally essential and the organization should be recognized as unique contributors to strengthening healthcare systems. By harnessing the diaspora as resourceful, skilled, experts, their passion should be reimbursed through the allocation of funds to support their strategic engagements required with both their membership and stakeholders.

Sustainability The organizations are independent in nature and the leadership is offered on a voluntary basis. They do not receive mainstream funding for their budgetary from the NHS which would support some of their projects and initiatives and offer sustainability for their valuable input. As an example, the volunteer study leave

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can be considered and made available to the leaderships of the organizations as a standard essential of their contracted time.

Representation Although most of the data analyzed in the report demonstrates a high representation of the NHS workforce, the NMC register shows a high proportion of BAME N&Ms are employed in the social care sector. Through a repeat study, more information and data can be therefore obtained as required to obtain a higher level of inclusion and representation of our social care workforce and achieve a more holistic perspective of all the organizations' functions and diversity of representation for all sectors.

Most of the organizations that completed the activity indicated that their organizations had been formed at the onset or during the pandemic lockdown in 2020. There appears to be a parallel connection between the pandemic and the impact and effect of the pandemic on the BAME HCPs in leading to the formation of the organizations. A comprehensive in-depth study is required to investigate and offer a better understanding of the connection, if any.

CONCLUSION AND RECOMMENDATION The organizations are strategic unique stakeholders, contributors, and liaisons to health interventions. As grassroots organizations, they provide professional connections and uphold their important role of disseminating relevant culturally

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competent healthcare information into the communities as discussed by BenRafael, (2013).

Suffice to note that as of 2024, there are now over thirty-six organizations and the results of this report reflect a fraction of those that participated in the activity. A further comprehensive investigation is required to fully investigate the functions, value, and contribution of the organizations as part of their joint objectives in strengthening healthcare systems and in order to obtain a comprehensive generalized representation.

Disclaimer At the time of publishing this report, two association leaders opted out of the survey however, the analysis of the results had already been completed.

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REFERENCES Adeoye, M.A., (2023) Review of sampling techniques for education. ASEAN Journal for Science Education, 2(2), pp.87-94 Aldridge, R. W., Lewer, D., Katikireddi, S. V., Mathur, R., Pathak, N., Burns, R., ... & Hayward, A. (2020). Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data. Wellcome open research, 5.

Ben-Rafael, E., (2013) Diaspora. Current sociology, 61(5-6), pp.842-861.

Canton, H., (2021) International Maritime Organization—IMO. In The Europa Directory of International Organizations 2021 (pp. 338-342). Routledge.

Ezeonwu, M., (2021) The Role of African Nurse Diaspora in Addressing Public Health Priorities in Africa. Global Qualitative Nursing Research, 8.

Palmer, C., (2000) The African Diaspora. The Black Scholar, 30(3-4), pp.56-59.

Rafferty, A.M. (2005) The Seductions of History and the Nursing Diaspora. Health and History. 7 (2), 2.

Schiller, N.G., Darieva, T. & Gruner-Domic, S. (2011) Defining cosmopolitan sociability in a transnational age. An introduction. Ethnic and Racial Studies. 34 (3), 399–418.

Teijlingen, E.V. & Hundley, V. (2002) The importance of pilot studies. Nursing Standard. 16 (40), 33–36.

Yeates, N. (2011) Going Global: The Trans-nationalization of Care: The Transnationalization of Care. Development and Change. 42 (4), 1109–1130.

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APPENDIX A INVENTORY LIST OF UK DIASPORA NURSING AND MIDWIFERY ORGANIZATIONS                                       

All Pakistani Nurses – Email: s.g.akhtar@gmail.com Association Isabel Zendal: Association of Spanish Nurses and Health Workers | Website Association of Senior Keralan Nurses – Email: bejoy.sebastian@nhs.net Association of South African Nurses, UK Website Association of South Asian Midwives | Website Association of Zambian Nurses, UK | X British Arab Nursing and Midwifery Association, UK | Website British Indian Nurses Association (BINA) Website British Sikh Nurses Website Cameroon Nurses and Midwives Association, UK Website Caribbean Nurses and Midwives Association UK (CNMA UK) Website Diaspora Uganda Nurses Midwives Society (DUNMS) https://www.nhccuganda.com |info@nhccuganda.com Filipino Nurses Association (FNA) United Kingdom Website Filipino Senior Nurses Alliance – Email: louie.horne1@nhs.net Gambia Healthcare Matters UK (GHM UK) Website Ghana Nurses Association (GNA UK) Website Hellenic British Midwives Association tzenikoutsi@gmail.com Hong Kong Nursing Association UK Website Italian Nurses and Midwives Association UK | X | Facebook Ivorian Association for Health Promotion, UK – Email: lydia.gnahoua@nhs.net Kairali Nurses Forum – Email: naveen.harikumar@nhs.net Kenyan Nurses Midwives A UK Association Website Malawian-UK Nurses Association for Advancement (MUNAA) Website Mauritian Nurses and Health Care Professionals UK – Email: s.pavaday@nhs.net Nurses Association of Jamaica UK (NAJ UK) Website Nepalese Nursing Association UK (NNAUK) Website Nigerian Nurses Charitable Association UK (NNCA UK) Website Philippine Nurses Association of United Kingdom (PNA UK) Website Portuguese Nurses Association – Email: daniela.costa2@nhs.net Refugee Nurses Association – Email: dima.abdulghani2000@gmail.com Romanian Nurses Association – Email: alex.pinzar@tgh.nhs.uk Society of African Caribbean Midwives – Email: marsha.jones@nhs.net Spanish Nurses Association https://isabelzendal.co.uk/ Sri Lankan Nurses Association – Email: dayani.baiai@nhs.net UK Tibetan Nurses Association – Email: samten.chodon1@nhs.net Ukraine Nurses Association – Email: kovyzhenko@yahoo.co.uk Uganda Nurses Midwives Association (UNMA-UK) | Website Union of UK Malayalee Associations (UUKMA) Nurses Forum Website Zimbabwe Midwifery and Nurses Association ((ZIMNA)| Website

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APPENDIX B TABLE SHOWING NATIONALITY REPRESENTATION IN THE NHS, 2023

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APPENDIX C TABLE SHOWING DIASPORA ENGAGEMENT OFFICES FROM ORIGIN/BIRTH COUNTRIES COUNTRY

ENGAGEMENT OFFICE

WEBSITE

YEAR ESTABLISHED

Algeria

Ministry of National Solidarity, Family and the National Community Abroad

Not available

Angola

Ministry of Foreign Affairs Institute of the Angolan Communities Abroad and Consulate Affairs

http://www.mirex.gov.ao

Not available

Bangladesh

Ministry of Expatriates’ Welfare and Overseas Employment (MEWOE)

http://www.probashi.gov.bd

2001

Benin

Ministry for Foreign Affairs, African Integration, the Francophone Community, and Beninese Abroad

Burkina Faso

Ministere Des Affaires Etrangres Et De La Cooperation Regionale

Burundi

Ministry of Foreign Affairs, Directorate of Diaspora

Dominica

Ministry of Trade, Industry, Consumer, Diaspora Affairs

Egypt

Ministry of Manpower and Emigration, Emigration Sector Higher Committee on Migration

Eritrea

Ministry of Foreign Affairs, Department of Eritreans Abroad

http://www.mfa.gov.et/Diaspora 1990’s /more.php?newsid=7

Ethiopia

Ministry of Foreign Affairs, Diaspora Affairs Directorate General; Ministry of Capacity Building, Diaspora Coordinating Office

http://www.mfa.gov.et/Diaspora 2002 /more.php?newsid=7

The Gambia

Ministry of Foreign Affairs, International Cooperation & Gambians Abroad

http://www.mofa.gov.gm/index. php?option=com_content&view=a rticle&id=58&Itemid=83

Not available

Ghana

Ministry of Interior, National Migration Unit

http://www.mfa.gov.gh/index.p hp?id=1

2003

Guinea

Ministry of Foreign Affairs and Guineans Abroad

No website. Contact no. +224 30 45 12 70

Not available

Guyana

Ministry of Foreign Affairs Diaspora Unit

http://www.minfor.gov.gy/index

Not available

Not available

http://www.mae.gov.bf

2007 Not available

http://www.dominica.gov.dm/e mployment-trade-industry-anddiaspora-affairs

Not available

Not available

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THE DIASPORA NURSING AND MIDWIFERY ORGANIZATIONS .php?option=com_content&task=v iew&id=70&Itemid=120 Jamaica

Diaspora and Consular Affairs Office

http://www.mfaft.gov.jm/jm/ab 1993 out-us/departmentsunits/diaspora-consular-affairs

Kenya

Ministry of Foreign Affairs: Diaspora Affairs Directorate

http://www.kenyaembassytlv.or g.il/209618/MINISTRY-OFFOREIGN-AFFAIRS-ON-DIASPORA

Lebanon

Ministry of Foreign Affairs and Emigrants

Lesotho

Association: Diaspora Alliance

http://lesothopretoria.com/?trad Not available e_14

Liberia

Ministry of states with no portfolio

http://www.emansion.gov.lr/2co 1972 ntent.php?sub=32&related=21&th ird=32&pg=sp http://www.mofa.gov.lr/public2 /doc/EOI%20FOR%20DIASPORA%2 0ADVISOR(Bank%20Comments)%20 (1).pdf

Malawi

Ministry of Foreign Affairs—Diaspora Services

http://www.foreignaffairs.gov.m w/index.php/diasporaservices/overview

Not available

Mali

Ministry of Malians Abroad and African Integration

http://www.ime.gob.mx

2002

Morocco

Ministry Charged with the Moroccan Community Residing Abroad

Mozambique

Institute for Mozambican Communities Living Abroad (INACE) in the Ministry of Foreign Affairs

http://www.iom.int/cms/en/site 2014 s/iom/home/news-andviews/press-briefing-notes/pbn2014b/pbn-listing/mozambiquelaunches-diaspora-eng.html

Niger

Ministry of African Integration and Nigerians Abroad Committee in Charge of Migration

http://www.messrs.ne/index.ph p?option=com_content&view=arti cle&id=70:ministere-des-affairesetrangeres-de-lintegrationafricaine-et-des-nigeriens-alexterieur&catid=1:liste-desappeles-du-service-civiquenational-pro&Itemid=67

Nigeria

Technical Working Group and Interministerial Committee on Migration

http://www.nigeriadiasporaday.c 2002 om/index.php/about/nnvs

Rwanda

Department on diaspora engagement, Ministry of External Relations and Internal Cooperation

http://www.minaffet.gov.rw/ind ex.php?id=890

19

2007

Not available

Not available

Not available

2008

THE DIASPORA NURSING AND MIDWIFERY ORGANIZATIONS Senegal

Ministry of Senegalese Abroad

http://www.diplomatie.gouv.sn

2003

Serbia

Ministry of Religion and Diaspora

http://www.mfa.gov.rs/en/cons ular-affairs/diaspora/diasporageneral-information

Sierra Leone

Office of the President, Office of the Diaspora

http://www.diasporaaffairs.gov. sl/index.php?option=com_conten t&view=article&id=1&Itemid=2

2007

Somalia

Ministry for Diaspora and Community Affairs Office for Development and Partnership with the Puntland Diaspora Community

http://www.mfa.somaligov.net https://www.facebook.com/Offi ceforDiasporaAffairs

2013

South Africa

Department of International Relations and http://www.dfa.gov.za Cooperation

Not available

South Sudan

Diaspora Engagement Steering Committee for South Sudan

https://www.facebook.com/sout hsudandiasporaforhealth

2013

Sri Lanka

Ministry of Foreign Employment Promotion and Welfare

http://www.foreignemploymin.g ov.lk

2010

Tanzania

Minister for Foreign Affairs and International Cooperation

http://www.foreign.go.tz

Not available

Togo

No apparent dept, but entire section of website dedicated to Togolese diaspora affairs

http://www.republicoftogo.com /Toutes-les-rubriques/Diaspora

Not available

Tunisia

Ministry of Social Affairs, Solidarity, and Tunisians Abroad

Uganda

Diaspora office in the ministry of foreign affairs

Not available http://www.mofa.go.ug/data/s menu/16/Overview-andMandate.html

2009

END.

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