Nursing Week: Women's health advocate Sheila Tlou on breaking barriers in the fight for global health equity
Over the past few decades, Tlou – a professor, nurse, HIV prevention advocate and artist – has merged her talents as a leader in health policy and community theatre to bring about lasting change in health outcomes in eastern and southern Africa.
“Nurses are a formidable and passionate force, and I say to all the young nurses out there, 'We can make an impact anywhere and everywhere we go,'” Tlou says.
Tlou will speak on May 9 at Innis College, sharing stories of her own experience as a changemaker in global health through her work with the World Health Organization (WHO), UNAIDS and the International Council of Nurses (ICN), where she has tackled issues around HIV transmission and prevention – particularly in women and children.
Of her many accomplishments, which have included being a member of parliament for the Republic of Botswana and director of a WHO nursing and midwifery initiative for anglophone Africa, Tlou says that she is most proud of her work saving the lives of children and their mothers by significantly lowering rates of HIV transmission in communities in Botswana.
When Tlou first became Botwana's minister of health in 2004, the rate of mother-to-child HIV transmission was very high. To address this urgent issue, Tlou created a comprehensive HIV/AIDS prevention strategy that included engaging with community members and leaders prior to rolling out an education and awareness campaign focused on HIV testing for pregnant women, as well as treatment with antiretrovirals.
By speaking with women and those supporting them in child-rearing – including partners and mothers-in-law – Tlou and her team of nurses, nurse practitioners and midwives were able to change the stigma around HIV and encourage early testing, shifting the community’s perspective and focus onto efforts that helped women birth healthy babies.
This community-engaged approach successfully reduced the rate of mother-to-child transmission of the disease from 30 per cent in 2003 to 8 per cent in 2008.
“This success was really saying to the world, 'Look at what can be achieved in a resource-limited area through the intervention of nurses,'” Tlou says. “Now the rate of transmission is less than 1 per cent, and the stigma is so low that many women continue to get tested. However the rates of infection of HIV among women remain very high, and that is still something that needs to be addressed.”
Tlou's advocacy has always been centered around issues of gender and empowering women to improve their health through education. Before she became a nurse, Tlou was passionate about theatre, originally planning to become an actor or interpreter for the United Nations because of her love of languages.
However, with only health sciences scholarships available to her as a young university student, Tlou entered the nursing program at Dillard University in New Orleans, opting to take public health and theatre as electives to foster her knack for engaging with people.
After completing her master’s degree in nursing education and instruction from Columbia University in New York City, Tlou returned to Botswana to teach community-health nursing and also co-directed a travelling theatre group that performed plays – some which imparted health-focused messages about family planning and spacing out pregnancies.
“Being able to take this practical public-health message out into the communities and villages was uplifting for the nursing students involved, because they could see the impact of community engagement from a nursing perspective,” Tlou says.
Though now retired, Tlou – who taught at the University of Botswana for decades – continues to work as a consultant on health promotion strategy for organizations such as the African Union, the United Nations and the WHO on efforts to reduce deaths from malaria, in addition to her work on HIV/AIDS.
During Nursing Week and beyond, Tlou wants nurses around the world to remember the importance not just of bedside care, but of community impact – and the ability of nurses to break down barriers that contribute to inequity in health care.
“My advice to current and future nurses is to look at the UN Sustainable Development Goals in your region, meet with nursing associations and find your niche,” Tlou says.
“As nurses, we need to make ourselves visible – and that includes in how we mentor the next generation."