1-MCN unit 1 framework (1).pdf

1ST SEMESTER CARE OF MOTHER, CHILD,...

1ST SEMESTER CARE OF MOTHER, CHILD, NCM ADOLESCENT (WELL CLIENTS) 2107 LECTURE/ SECOND YEAR Clementir, A.G. BSN2B Unit 1 Maternal and Child Health Nursing Practice Chapter 1: A Framework for Maternal and Child Health Nursing Nursing Theory Goals and Philosophies of Maternal and Child Health Nursing One of the requirements of a profession (together with other critical determinants, such as member-set standards, monitoring of practice “Obstetrics” - care of women during child birth, is derived from the quality, and participation in research) is that the concentration of a Greek word obstare, which means “to keep watch.” discipline’s knowledge flows from a base of established theory. “Pediatrics” - "child", is a word derived from the Greek word pais. Nursing theorists offer helpful ways to view clients so that nursing activities can best meet client needs- for example, by seeing a pregnant woman not simply as a physical form but as a dynamic force with Maternal and child health nursing is: important psychosocial needs, or by viewing children as extensions or Family centered; assessment should always include the family as well as an active members of a family as well as independent beings. individual. Only with this broad theoretical focus can nurses appreciate the Community centered; the health of families is both affected by and significant effect on a family of a child’s illness or of the introduction of a influences the health of communities. new member. Evidence based; this is the means whereby critical knowledge increases. A challenging role for nurses and a major factor in keeping families well and Evidence-Based Practice optimally functioning. Is the conscientious, explicit, and judicious use of current best evidence The primary goal of maternal and child health nursing: in making decisions about the care of patients. Evidence can be a combination of research, clinical expertise, and patient preferences or “The promotion and maintenance of optimal family health to ensure cycles of values. optimal childbearing and childrearing” involves the use of research or controlled investigation of a problem in conjunction with clinical expertise as a foundation for action. bodies of professional knowledge grow and expand to the extent that Major Philosophical Assumptions about Maternal and Child people in that profession plan and carry out research Health Nursing Philosophy of Maternal and Child Health Nursing Nursing Research A maternal and child health nurse serves as an advocate to protect the rights of all family members, including the fetus. (the systematic investigation of problems that have implications for Maternal and child health nursing includes a high degree of independent nursing practice and usually carried out by nurses) plays an important nursing function because teaching and counseling are so frequently role in evidence-based practice as bodies of professional knowledge only required. grow and expand to the extent people in that profession are able to carry Promoting health is an important nursing role because this protects the out research. health of the next generation. Examining nursing care in this way results in improved and cost-effective Pregnancy or childhood illness can be stressful and can alter family life in patient care as it provides evidence for action and justification for both subtle and extensive ways. implementing activities. Personal, cultural, and religious attitudes and beliefs influence the meaning of illness and its impact on the family. Circumstances such as illness or pregnancy are meaningful only in the context of a total life. Four Phases of Health Care Maternal and child health nursing is a challenging role for a nurse and is a major factor in promoting high-level wellness in families. A. Health Promotion Definition: Framework for Maternal and Child Health Nursing Educating clients to be aware of good health through teaching and role modeling. Maternal and child health nursing can be visualized within a framework: Example: Nursing Process Teaching women the importance of rubella immunization before Nursing Theory pregnancy; teaching children the importance of safer sex practices. Evidence-based practice Care for families during childbearing and childrearing years, through four B. Health Maintenance phases of health care. Definition: Nursing Process Intervening to maintain health when risk of illness is present. A proven form of problem solving based on the scientific method, serves Example: as the basis Encouraging mother to come to prenatal care; teaching parents the That the nursing process is applicable to all health care teachings, from importance of safeguarding their home by childproofing it against the prenatal clinic to pediatric intensive care unit, a proof that the method poisoning. is broad enough to serve as the basis for all nursing care  1ST SEMESTER CARE OF MOTHER, CHILD, NCM ADOLESCENT (WELL CLIENTS) 2107 LECTURE/ SECOND YEAR Clementir, A.G. BSN2B Unit 1 Maternal and Child Health Nursing Practice C. Health Restoration Standards of Professional Performance Definition: Standard I: Quality of Care The pediatric nurse systematically evaluates the quality and effectiveness Promptly diagnosing and treating illness using interventions that will return of pediatric nursing practice client to wellness most rapidly. Example: Standard II: Performance Appraisal Caring for a woman during a complication of pregnancy or a child The pediatric nurse evaluates his or her own nursing practice in relation during an acute illness. to professional practice standards and relevant statutes and regulations. D. Health Rehabilitation Standard III: Education The pediatric nurse acquires and maintain current knowledge and Definition: competency in pediatric nursing practice. Preventing further complications from an illness; bringing client back to optimal state of wellness or helping client to accept inevitable death. Standard IV: Collegiality The pediatric nurse interacts with and contributes to the professional Example: development of peers, colleagues, and other health care providers. Encouraging a woman with gestational trophoblastic disease to continue therapy or a child with a renal transplant to continue to take Standard V: Ethics necessary medications. The pediatric nurse’s assessment, actions, and recommendations on behalf of children and their families are determined in an ethical manner Maternal and Child Health Goals and Standards Standard VI: Collaboration The pediatric nurse collaborates with the child, family, and other health In maternal-child health, standards have been developed by the Division of care providers in providing client care. Maternal-Child Health Nursing practice of the American Nurses Association in collaboration with the Society of Pediatric Nurses. Standard VII: Research The pediatric nurse contributes to nursing and pediatric health care through the use of research methods and findings. American Nurses Association/ Society of Pediatric Nurses Standards of Care and Professional Performance Standard VIII: Resource Utilization Standards of Care The pediatric nurse considers factors related to safety, effectiveness, and Comprehensive pediatric nursing care focuses on helping children and cost in planning and delivering patient care. their families and communities achieve their optimum health potentials. This is best achieved within the framework of family- centered care and Association of Women’s Health, Obstetric, and Neonatal Nurses the nursing process, including primary, secondary and tertiary care (AWHONN) coordinated across health care and community settings. The Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) has developed similar standards for the nursing care of Standard I: Assessment women and newborns. The pediatric nurse collects patient health data. Standard I: Quality of Care Standard II: Diagnosis The nurse systematically evaluates the quality and effectiveness of The pediatric nurse analyzes the assessment data in determining nursing practice. diagnoses. Standard II: Performance Appraisal Standard III: Outcome Identification The nurse evaluates his/her own nursing practice in relation to The pediatric nurse identifies expected outcomes individualized to the professional practice standards and relevant statutes and regulations child and the family. Standard III: Education Standard IV: Planning The nurse acquires and maintains current knowledge in nursing practice. The pediatric nurse develops a plan of care that prescribes interventions to obtain expected outcomes. Standard IV: Collegiality The nurse contributes to the professional development of peers, Standard V: Implementation colleagues, and others. The pediatric nurse implements the interventions identified in the plan of care. Standard V: Ethics The nurse’s decision and actions on behalf of patients are determined in Standard VI: Evaluation an ethical manner. The pediatric nurse evaluates the child’s and family’s progress toward attainment of outcomes. Standard VI: Collaboration The nurse collaborates with the patient, significant others, and health care providers in providing patient care.  1ST SEMESTER CARE OF MOTHER, CHILD, NCM ADOLESCENT (WELL CLIENTS) 2107 LECTURE/ SECOND YEAR Clementir, A.G. BSN2B Unit 1 Maternal and Child Health Nursing Practice Theorist: Florence Nightingale Standard VII: Research The nurse uses research findings in practice. Founder of modern nursing Florence Nightingale’s Environment Theory changed the face of nursing Standard VIII: Resource Utilization practice. She served as a nurse during the Crimean War, at which time The nurse considers factors related to safety, effectiveness, and cost in she observed a correlation between the patients who died and their planning and delivering patient care. environmental conditions. As a result of her observations, the Environment Theory of nursing was born. Nightingale explained this Standard IX: Practice Environment theory in her book, Notes on Nursing: What it is, What it is Not. The nurse contributes to the environment of care delivery within the The model of nursing that developed from Nightingale, who is considered practice settings. the first nursing theorist, contains elements that have not changed since the establishment of the modern nursing profession. Though this Standard X: Accountability theory was pioneering at the time it was created, the principles it applies The nurse in is professionally and legally accountable for his/ her are timeless. practice. The professional registered nurse may delegate to and The role of the nurse is viewed as changing or structuring elements of the supervise qualified personnel who provide patient care environment such as ventilation, temperature, odors, noise, and light to put the client into the best opportunity for recovery 2020 National Health Goals The 2020 National Health Goals are intended to help citizens more easily Theorist: Betty Neuman understand the importance of health promotion and disease prevention and Major Concept of Theory: to encourage wide participation in improving health in the next decade. A person is an open system that interacts with the environment; nursing The two main overarching national health goals are: is aimed at reducing stressors through primary, secondary and tertiary Increase quality and years of healthy life. prevention. Eliminate health disparities. Betty Neuman’s Systems Model provides a comprehensive holistic and Global Health Goals system-based approach to nursing that contains an element of flexibility. The End poverty and hunger. theory focuses on the response of the patient system to actual or potential Achieve universal primary education. environmental stressors and the use of primary, secondary, and tertiary Promote gender equality and empower women. nursing prevention intervention for retention, attainment, and maintenance of Reduce child mortality. patient system wellness. Improve maternal health. Combat HIV/AIDS, malaria, and other diseases. Theorist: Dorothea Orem Ensure environmental sustainability. Major Concept of Theory: Develop a global partnership for development. The focus of nursing is on the individual; clients are assessed in terms of Improve maternal health. ability to complete self-care. Care given may be wholly compensatory Combat HIV/AIDS, malaria, and other diseases. (client has no role); partly compensatory (client participates in care); or Ensure environmental sustainability. supportive-educational. Develop a global partnership for development. The Self-Care Deficit Theory developed as a result of Dorothea E. Orem working toward her goal of improving the quality of nursing in general Theories Related to Maternal and Child Nursing hospitals in her state. The model interrelates concepts in such a way as to Theorist: Patricia Benner create a different way of looking at a particular phenomenon. The theory is Major Concept of Theory: relatively simple, but generalizable to apply to a wide variety of patients. It Nursing is a caring relationship. Nurses grow from novice to expert as can be used by nurses to guide and improve practice, but it must be they practice in clinical settings. consistent with other validated theories, laws and principles. Theorist: Dorothy Johnson Theorist: Ida Jean Orlando Major Concept of Theory: Major Concept of Theory: A person comprises subsystems that must remain in balance for optimal The focus of the nurse is interaction with the client: effectiveness of care functioning. Any actual or potential threat to this system balance is a depends on the client’s behavior and the nurse’s reaction to that nursing concern. behavior. The client should define her own needs. Theorist: Imogene King The Dynamic Nurse-Patient Relationship, published in 1961 and written by Major Concept of Theory: Ida Jean Orlando, described Orlando’s Nursing Process Discipline Theory. Nursing is a process of action, reaction, interaction, and transaction; The major dimensions of the model explain that the role of the nurse is to find needs are identified based on client’s social system, perceptions, and out and meet the patient’s immediate needs for help. The patient’s presenting health; the role of the nurse is to help; the client achieved goal behavior might be a cry for help. However, the help the patient needs may attainment. not be what it appears to be. Because of this, nurses have to use their own Theorist: Madeline Leininger perception, thoughts about perception, or the feeling engendered from their Major Concept of Theory: thoughts to explore the meaning of the patient’s behavior. This process helps The essence of nursing is care. To provide transcultural care, the nurse nurses find out the nature of the patient’s distress and provide the help he or focuses on the study and analysis of different cultures with respect to she needs. caring behaviors.  1ST SEMESTER CARE OF MOTHER, CHILD, NCM ADOLESCENT (WELL CLIENTS) 2107 LECTURE/ SECOND YEAR Clementir, A.G. BSN2B Unit 1 Maternal and Child Health Nursing Practice Theorist: Rosemarie Rizzo Parse Theorist: Dr. Kolcaba Major Concept of Theory: Kolcaba’s Theory of Comfort Nursing is a human science. Health is a lived experience. Man-living- Was first developed in the 1990s. It is a middle-range theory for health health as a single unit guides practice. practice, education, and research. This theory has the potential to place comfort in the forefront of healthcare. According to the model, comfort is Parse’s Human Becoming Theory an immediate desirable outcome of nursing care. Parse’s Human Becoming Theory guides the practice of nurses to focus on quality of life as it is described and lived. The human becoming theory Theorist: Ramona Mercer of nursing presents an alternative to both the conventional bio- medical The Maternal Role Attainment Theory approach as well as the bio-psychosocial-spiritual approach of most other Was developed to serve as a framework for nurses to provide appropriate theories and models of nursing. Parse’s model rates quality of life from health care interventions for nontraditional mothers in order for them to each person’s own perspective as the goal of the practice of nursing. develop a strong maternal identity. This mid- range theory can be used Rosemarie Rizzo Parse first published the theory in 1981 as the “Man- throughout pregnancy and postnatal care, but is also beneficial for living-health” theory, and the name was changed to the “human becoming adoptive or foster mothers, or others who find themselves in the maternal theory” in 1992. role unexpectedly. The process used in this nursing model helps the mother develop an attachment to the infant, which in turn helps the infant Theorist: Hildegard Peplau form a bond with the mother. This helps develop the mother-child Major Concept of Theory: relationship as the infant grows. The promotion of health is viewed as the forward movement of the The primary concept of this theory is the developmental and personality; this is accomplished through an interpersonal process that interactional process, which occurs over a period of time. In the process, includes orientation, identification, exploitation, and resolution. the mother bonds with the infant, acquires competence in general caretaking tasks, and then comes to express joy and pleasure in her role Theorist: Martha Rogers as a mother Major Concept of Theory: The purpose of nursing is to move the client toward optimal health; the nurse should view the client as whole and constantly changing and help Roles and Responsibilities of Maternal and Child Nurse people to interact in the best way possible with the environment. Advanced – Practice Roles for Nurses in Maternal and Child Health Martha E. Rogers’ Theory of Unitary Human Beings As trends in maternal and child health care change, so do the roles of Views nursing as both a science and an art. The uniqueness of nursing, maternal and child health nurses. All maternal and child health nurse’s like any other science, is in the phenomenon central to its focus. The functions in a variety of settings as caregivers, client advocates, purpose of nurses is to promote health and well-being for all persons researchers, case managers, and educators. wherever they are. The development of Rogers’ abstract system was Many nurses with a specified number of years of direct patient care, strongly influenced by an early grounding in arts, as well as a background clinical expertise, and validated completion of pertinent continuing in science and interest in space. The science of unitary human beings education programs are certified in their specialty. In addition, maternal began as a synthesis of ideas and facts. and child health nurse’s function in a variety of advanced-practice roles. Theorist: Sister Callista Roy Major Concept of Theory: The role of the nurse is to aid clients to adapt to the change caused by 1. Clinical Nurse Specialists illness; levels of adaptation depend on the degree of environmental A clinical nurse specialist (CNS) is an advanced practice nurse who has change and state of coping ability; full adaptation includes physiologic hands-on expertise, advanced knowledge, and a certification in a given interdependence. specialty. The graduate-level nursing education and extensive training that the CNS must go through preparing them to practice autonomously The Adaptation Model of Nursing and to adequately assess, diagnose, and manage patient problems. Was developed by Sister Callista Roy in 1976. After working with Dorothy The type of specialty area that a clinical nurse specialist works in is E. Johnson, Roy became convinced of the importance of describing the defined by the patient population types that they're treating, the kind of nature of nursing as a service to society. This prompted her to begin care needed, the medical setting, or the type of disease or illness. developing her model with the goal of nursing being to promote Although they're both advanced nurses, clinical nurse specialists adaptation. She first began organizing her theory of nursing as she shouldn't be confused with nurse practitioners as their respective scopes developed course curriculum for nursing students at Mount St. Mary’s of practice are different. College. She introduced her ideas as a basis for an integrated nursing curriculum Whereas nurse practitioners tend to carry out tasks like taking patients' health history and acting as their primary care provider, clinical nurse Theorist: Jean Watson specialists usually tend to focus on research, education and consulting. The Philosophy and Science of Caring has four major concepts: human being, health, environment/society, and nursing. Jean Watson refers to the human being as “a valued person in and of him or herself to be cared for, respected, nurtured, understood and assisted; in a general philosophical view of a person as a fully functional integrated self. Human is viewed as greater than and different from the sum of his or her parts  1ST SEMESTER CARE OF MOTHER, CHILD, NCM ADOLESCENT (WELL CLIENTS) 2107 LECTURE/ SECOND YEAR Clementir, A.G. BSN2B Unit 1 Maternal and Child Health Nursing Practice 2. Case Manager 6. Pediatric Nurse Practitioner A nurse case manager is a medical professional who's responsible for Pediatric nurse practitioners (PNPs) are advanced practice nurses who coordinating the long-term care of patients. They update the patient care provide primary and specialty care to children from infancy through young plans according to the patient's condition and educate both the patient adulthood. These nurses are crucial members of the healthcare team and and their families on how to follow the plan. generally work alongside pediatricians, although some work A nurse case manager, also known as an RN case manager, is tasked with independently in their own private practices. As nurses, PNPs tend to evaluating patients and implementing health care plans for them on an take a more holistic approach to medicine than their physician individual basis. Their primary responsibilities include: counterparts. Evaluating new patients and updating or revising health care plans as While gathering information about a patient's physical symptoms is crucial necessary based on the assessment to providing effective patient care, understanding environmental and Explaining the health care plan to the patient and their families, along psychosocial factors are seen as equally important for PNPs. Although with options they may have for their care plan most PNPs work in primary care, many PNPs find themselves working in Making clinical decisions while conducting routine care for patients pediatric subspecialties like neurology, psychiatry/mental health, Accurately documenting and submitting medical records oncology, cardiology, gastroenterology, infectious disease, and more. Creating and maintaining an environment for open communication Reviewing the results of medical tests 7. Nurse-Midwife Following physician orders and implementing other nursing procedures Midwives have helped women to deliver babies for centuries and they Continually assessing the patient to fully understand their needs were present at most births until the early twentieth century. Today, more Actively demonstrating their knowledge of patient care, including how to than 7% of all births, both vaginal and C-section, in the U.S. are delivered administer medication, monitor the patient for symptoms, perform by certified nurse-midwives. diagnostic procedures and conduct other types of treatments Nurse-midwifery developed in the U.S. throughout the twentieth century when the Frontier Medical Service was founded in 1925. This early 3. Women’s Health Nurse Practitioner practice used registered nurses that were trained in nurse-midwifery in A women's health nurse practitioner (WHNP) is an advanced-practice England. Throughout the 1900s, nurse-midwives, or midwives with nurse who provides primary care services to women across their medical training, revived the practice of having a midwife present at birth. lifespans. These nurses primarily focus on obstetric, gynecological, and Today, a certified nurse-wife is a registered nurse who is qualified to give reproductive health. Not only do they provide diagnostic care and care during pre-conception, throughout pregnancy, during birth, and in treatment, but they also employ preventative health measures. the postpartum phase. They are able to provide women with a more low- tech approach to birthing, as they guide women through safe, natural It's important to distinguish WHNPs from certified nurse- midwives (CNMs). birth techniques. While the clinical focus of a CNM tends to be centered around childbearing, In addition to assisting women through childbirth, a certified nurse- from conception to delivery, a WHNP treats female patients over their entire midwife offers holistic care to women at many different stages of life. lifespan and does so mainly in a primary care office setting, as opposed to in They conduct physical exams, diagnose and treat medical conditions, a hospital or delivery room. and may even write prescriptions for certain conditions. Nurse-midwives also advise and counsel mothers-to-be. 4. Family Nurse Practitioner A family nurse practitioner, or FNP, is a highly educated registered nurse Certified nurse-midwives may practice nurse-midwifery in a number of who provides primary or specialty care for patients of all ages. These settings, including: advanced practice registered nurses (APRNs) typically work under a Hospitals physician but with a high degree of autonomy, and in some cases, have OB/GYN their own private practices. Clinics Health clinics They provide most of the same services a doctor provides, and are the Birthing centers primary source of care for many patients. FNPs conduct health exams, Midwifery practices provide health education, diagnose illnesses, and prescribe medication, Private homes among many other tasks. A nurse-midwife can give women primary care in addition to 5. Neonatal Nurse Practitioner gynecological care. They can provide holistic care to women who are Neonatal nurse practitioners (NNPs) are advanced practice registered going through menopause or perimenopause. A nurse- midwife can even nurses (APRNs) who are responsible for providing primary, acute, treat a woman’s male partner who is experiencing a sexually transmitted chronic, and critical care to ill neonates, infants, and toddlers under the disease (STD). age of two in the neonatal intensive care unit (NICU). These nurses have Nurse-midwives offer women a more holistic approach to childbirth than undergone graduate-degree training in nursing at either the master's or modern gynecologists and obstetricians do. This approach calls for little doctoral level, and are board-certified in neonatology. or no technology involved in birth. However, a nurse-midwife is trained to know which situations may call for the help of an obstetrician during birth. Commonly encountered medical issues that NNPs must be able to deal with During pregnancy, a nurse-midwife monitors the health of both the in a clinically effective manner include congenital heart abnormalities, mother and the baby. They help the mother to make a birth plan and offer prematurity, infections, respiratory problems, low birth weights, and more. In individualized advice to each woman. When the time comes, nurse- this specialty, advanced skills in physical and psychosocial assessments of midwives assist in the delivery and then provide aftercare to both the newborns are an absolute must. Although NNPs technically work under the mother and baby. A nurse-midwife can provide newborn care during the instruction of a neonatologist M.D. or fellow, they do hold what's known as first month of the baby’s life. ‘prescriptive authority' which allows them to prescribe medications to their patients  1ST SEMESTER CARE OF MOTHER, CHILD, NCM ADOLESCENT (WELL CLIENTS) 2107 LECTURE/ SECOND YEAR Clementir, A.G. BSN2B Unit 1 Maternal and Child Health Nursing Practice Nurse-Midwife cont. In 2013, the General Assembly set up a 30-member Open Working A maternal-child nurse is often cross trained. They must retain skills and Group to develop a proposal on the SDGs. knowledge that allow them to assist the patient during the entire hospital In January 2015, the General Assembly began the negotiation process on stay. the post-2015 development agenda. The process culminated in the The maternal-child nurse serves in roles related to labor, delivery, subsequent adoption of the 2030 Agenda for Sustainable Development, recovery, operational, postpartum and management of high-risk with 17 SDGs at its core, at the UN Sustainable Development Summit in pregnancies. September 2015. Children’s nurses plan and provide holistic nursing care to children 2015 was a landmark year for multilateralism and international policy affected by a wide variety of illnesses and medical conditions. shaping, with the adoption of several major agreements: Sendai Framework for Disaster Risk Reduction (March 2015) Typical responsibilities include: Addis Ababa Action Agenda on Financing for Development (July 2015) Assessing and planning nursing care requirements Transforming our world: the 2030 Agenda for Sustainable Development Providing care before and after operations with its 17 SDGs was adopted at the UN Sustainable Development Monitoring and administering medication, injections and intravenous infusions Summit in New York in September 2015. Treating wounds Taking samples from patients and monitoring their pulse, temperature and Paris Agreement on Climate Change (December 2015) blood pressure Now, the annual High-level Political Forum on Sustainable Development Checking on the condition of patients serves as the central UN platform for the follow-up and review of the Dealing with emergencies SDGs. Supervising junior staff Today, the Division for Sustainable Development Goals (DSDG) in the Organizing workloads United Nations Department of Economic and Social Affairs (UNDESA) Tutoring student nurses provides substantive support and capacity-building for the SDGs and their Obtaining parental consent for treatment related thematic issues, including water, energy, climate, oceans, Writing records urbanization, transport, science and technology, the Global Sustainable Providing information, emotional support and reassurance to patients and Development Report (GSDR), partnerships and Small Island Developing relatives States. DSDG plays a key role in the evaluation of UN systemwide implementation of the 2030 Agenda and on advocacy and outreach The 2030 Agenda for Sustainable Development activities relating to the SDGs. In order to make the 2030 Agenda a reality, broad ownership of the SDGs must translate into a strong History: commitment by all stakeholders to implement the global goals. DSDG Adopted by all United Nations Member States in 2015, provides a shared aims to help facilitate this engagement. blueprint for peace and prosperity for people and the planet, now and into the future. At its heart are the 17 Sustainable Development Goals (SDGs), which are an urgent call for action by all countries - developed and WHO’s 17 Sustainable Development Goals developing - in a global partnership. They recognize that ending poverty and other deprivations must go hand-in-hand with strategies that improve. End poverty in all its forms everywhere health and education, reduce inequality, and spur economic growth – all 2. End hunger, achieve food security and improved nutrition and promote while tackling climate change and working to preserve our oceans and sustainable agriculture forests. 3. Ensure healthy lives and promote well- being for all at all ages 4. Ensure inclusive and equitable quality education and promote lifelong learning The SDGs build on decades of work by countries and the UN, including opportunities for all. the UN Department of Economic and Social Affairs 5. Achieve gender equality and empower all women and girls In June 1992, at the Earth Summit in Rio de Janeiro, Brazil, more than 6. Ensure availability and sustainable management of water and sanitation for all 178 countries adopted Agenda 21, a comprehensive plan of action to 7. Ensure access to affordable, reliable, sustainable and modern energy for all build a global partnership for sustainable development to improve human 8. Promote sustained, inclusive and sustainable economic growth, full and lives and protect the environment. productive employment and decent work for all. Member States unanimously adopted the Millennium Declaration at the 9. Build resilient infrastructure, promote inclusive and sustainable industrialization Millennium Summit in September 2000 at UN Headquarters in New York. and foster innovation The Summit led to the elaboration of eight Millennium Development 10. Reduce inequality within and among countries Goals (MDGs) to reduce extreme poverty by 2015. 11. Make cities and human settlements inclusive, safe, resilient and sustainable The Johannesburg Declaration on Sustainable Development and the Plan 12. Ensure sustainable consumption and production patterns of Implementation, adopted at the World Summit on Sustainable 13. Take urgent action to combat climate change and its impacts Development in South Africa in 2002, reaffirmed the global community's 14. Conserve and sustainably use the oceans, seas and marine resources for commitments to poverty eradication and the environment, and built on sustainable development Agenda 21 and the Millennium Declaration by including more emphasis 15. Protect, restore and promote sustainable use of terrestrial ecosystems, on multilateral partnerships. sustainably manage forests, combat desertification, and halt and reverse At the United Nations Conference on Sustainable Development (Rio+20) land degradation and halt biodiversity loss. in Rio de Janeiro, Brazil, in June 2012, Member States adopted the 16. Promote peaceful and inclusive societies for sustainable development, outcome document "The Future We Want" in which they decided, inter provide access to justice for all and build effective, accountable and alia, to launch a process to develop a set of SDGs to build upon the inclusive institutions at all levels MDGs and to establish the UN High-level Political Forum on Sustainable 17. Strengthen the means of implementation and revitalize the global Development. The Rio +20 outcome also contained other measures for partnership for sustainable development implementing sustainable development, including mandates for future programs of work in development financing, small island developing states and more.