Pediatrics and Neonatal Nursing - Sci Forschen

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Mini Review
The International Child Health Nursing Network (Red ENSI): A Collaboration Strategy

  María Carmen Sellán Soto1,3      Antonio Vázquez Sellán 2,3      María Luisa Díaz Martínez1,3*   

1School of Medicine, UAM, Madrid, Spain
2San Rafael-Nebrija, Nebrija University, Madrid, Spain
3Red ENSI (Spain)

*Corresponding author: María Luisa Díaz Martínez, School of Medicine, UAM, Madrid, Spain, E-mail:

The purpose of this article is to present the use of networks as a strategy of work and collaboration to improve the health of the population, which, in our case, is the health of children and adolescents.

The International Child Health Nursing Network (ENSI Network;, in Spanish, Red Internacional de Enfermería en Salud Infantil (Red ENSI), is the strategy for cooperation among institutions involved in training nurses and is aimed at enhancing national health systems.


Three key messages were included in the World Health Organization’s 2013 report on world health, Research on universal health coverage [1]:

  1. Universal health coverage cannot be achieved without the results provided by research.
  2. All nations must receive and produce research.
  3. Research has to receive national and international support.

In the resolution adopted in 2005, Member States of the World Health Organization called for universal health coverage in two facets: the provision and access to high quality health and protection against the economic risks of the people who need such services [1].

Significant progress has been made in several areas, such as in the Millennium Development Goals. “The Millennium Development Goals (MDGs) are the world’s time-bound and quantified targets for addressing extreme poverty in its many dimensions-income poverty, hunger, disease, lack of adequate shelter, and exclusion-while promoting gender equality, education, and environmental sustainability. They are also basic human rights-the rights of each person on the planet to health, education, shelter, and security” [2].

This important progress includes the following relevant figures:

  • The global under-five mortality rate has been reduced by more than half, from 90 to 43 deaths per thousand live births between 1990 and 2015.
  • Since 1990, the maternal mortality ratio has fallen by 45% worldwide, and most of that reduction has occurred since the year 2000.
  • Globally, over 71 per cent of births were assisted by skilled health personnel in 2014, an increase from 59 % in 1990 [3].

Despite these advances, there are still major concerns regarding the poor health of the population and great difficulties in accessing services with minimum guarantees. Another aspect in which there are still major issues requiring attention is the number of existing health professionals and the differences in their training.

The Regional Observatory of Human Resources for Health (Pan American Health Organization) states that nurses “are in the line of action in providing health services and play an important role in patientcentered care. In many countries, they are leaders or key players in the multidisciplinary and interdisciplinary health teams. They provide a wide range of nursing services at all levels of the health system”. The factors involved include the political and economic differences among countries, migration of professionals, employment conditions or the lack of professional regulation [4].

Bearing in mind that quality health coverage requires a workforce with quality training in adequate numbers, according to the needs of each country, the Governing Council of the Pan American Health Organization recently adopted the resolution “Human resources for health: increasing access to qualified health workers in primary health care-based health Systems”, which urges Member States to promote reforms in the training of health care professionals to support health systems based on primary health care and to increase the number of jobs in primary health care professions, including advanced practice nurses [4].

In 2006, the Pan American and World Health Organizations, through the Nursing Human Resources Advisory Unit, promoted the creation of thematic nursing networks with the aim of enhancing the training of health personnel and improving access of the population to health services.

The Unit of Child and Adolescent Health, together with the Unit for Human Resources for Health, Area of Health Systems Strengthening of the Pan American Health Organization (PAHO), concerned with child health indicators in many Latin American countries, requested the Latin American Association of Schools and Colleges of Nursing (ALADEFE) to conduct a study to assess the strengths and weaknesses of child health education in schools of nursing in Latin America. The study, entitled “The Teaching of Child Health in Schools and Colleges of Nursing in Latin America“ [5], was presented at the 9th Pan American Nursing Research Symposium in 2004, and published by PAHO. The results highlighted the need to seek teaching strategies to improve child health in the region, as well as enhancing the knowledge and efforts of actors committed to the development of health.

ENSI Network

Set up in 2006, under the auspices of the Pan American Health Organization (PAHO), the ENSI Network is based on the principle that the development of professional competencies in attending children and adolescents is fundamental to implementing policies to attend the health needs of the population.

By agreement of its members, the International Child Health Nursing Network (Red ENSI) is the joint strategy and technical cooperation among institutions directly or indirectly involved in the training of nursing professionals in order to strengthen national health systems. It assumes that the development of competences of the professionals dedicated to the care of children and adolescents is critical to implementing policies that address health needs.Currently,19 Ibero-American countries belong to this child health nursing network.

At present, the members of the Regional Coordinating Group are Maricela Torres (Cuba) as Coordinator; Lynda Wilson (USA) as Deputy Coordinator; Elba Isaza (Panama) as Technical Secretary; Lia Fernández (Uruguay) as Secretary of Communication; Carmen Sellán (Spain) as Project Secretary and Edelmira Osegueda (El Salvador) as Secretary of Scientific Production.

ENSI Spain

Spain’s national network, ENSI Spain, was set up in 2011 in the framework of the 5th International Nursing Networks Meeting held in Portugal, with Carmen Sellán being named as Coordinator. Carmen Sellán has since left the Secretariat Project and is the new Deputy Coordinator of the Regional Group

The Network’s objectives include the following:
  • Promote coordination among members to expand and strengthen its activities in care, teaching, research and technical cooperation in the area of child health.
  • Give visibility to the situation and trends in child health nursing, facilitating the identification of priorities for change and development.
  • Promote production and intensive scientific, technical and referential information about children’s health.
  • Share experiences and teaching methods in child health.
  • To promote the defense of the rights of children and adolescents in all instances.
  • Promote healthy environments for children at different stages of development.

ENSI Spain comprises both individual and institutional members, including professionals from various fields and graduate and postgraduate nursing students. Its upcoming projects include working on emerging and prevalent processes in neonatal, pediatric and adolescent populations; the analysis and methodological evaluation of Integrated Management of Childhood Illness (IMCI) and visibility and dissemination of the network.

This project is conducting a qualitative action research method in schools in Madrid with children between 7 and 10 years of age. The aims of this project are to:

  1. Characterize shared representations about gender in girls and boys.
  2. Identify the contribution of cultural events for understanding gender approaches.
  3. Identify children’s perceptions of nurses.

We are currently analyzing the data collected from a sample of 102 children at a public school in Madrid. Preliminary results suggest, for example, that children begin to build their gender roles from an early age, involving the same behaviors, games, professions and activities.

As members of the Network, ENSI Spain considers it essential to promote healthy growth and development of children. We consider it important to work with children from an early age so that they can learn to establish flexible and equitable relations of mutual respect.

ENSI Spain is also working on another international research project, “The construction process of the nursing professional identity: a transcultural perspective”, a project involving several centers in Mexico, Uruguay, Cuba, Venezuela and Spain.

Our working hypothesis is that the psychosocial problems that nurses face (job dissatisfaction, burnout, conflict, etc.) are directly related to a historical mismanagement of the process of developing their professional identity. Our overall objective is to analyze the similarities and differences in configuration processes that nurses identify, as compared across different cultural traditions.

Finally, we would like to point out that the underlying philosophy of the ENSI Network is based on the conviction that an excellent strategy to develop the practice, management, research and nursing education would be to encourage and support horizontal cooperation and solidarity as it enhances professional skills in universal health coverage, and in universal access to nursing care and health care quality. Networks are pockets for sharing knowledge, experiences, and provide the opportunity to carry out international and multicentre research that can lead to significant results in improving quality of life.


  1. Dye C, Boerma T, Evans D, Harries A, Lienhardt C, et al. (2013) Research for universal health coverage: World health report 2013. World Health Organization. [Ref.]
  2. Millennium Project (2006) What they are. [Ref.]
  3. United Nations (UN) (2015) The Millennium Development Goals Report 2015. [Ref.]
  4. Organizacion Panamericana de la Salud (2012) Pan American Health Organitation. [Ref.]
  5. Benguigui Y, Malvárez S, Obregón R (2005) La Enseñanza de la Salud Infantil en las Escuelas y Facultades de Enfermería de América Latina. [Ref.]

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Article Information

Article Type: Mini Review

Citation: Sellán Soto MC, Vázquez Sellán A, Díaz Martínez ML (2016) The International Child Health Nursing Network (Red ENSI): A Collaboration Strategy. Pediatr Neonatal Nurs Open Access 2(3): doi

Copyright: © 2016 Sellán Soto MC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication history: 

  • Received date: 25 Jul 2016

  • Accepted date: 12 Sep 2016

  • Published date: 16 Sep 2016