title: Advancing nursing enterprises: A cross-country comparison.
abstract: BACKGROUND
  Health system transformations in the United States are creating new opportunities for nursing innovation, although financial sustainability has limited the expansion of nurse managed clinics.
  
  
  OBJECTIVE
  We explore case studies of nursing enterprises in the developing world and discuss their potential for informing related work in the United States.
  
  
  METHODS
  Cases were selected from the Center for Health Market Innovations.
  
  
  CONCLUSIONS
  We describe a professional association network of clinics in Tanzania, a social franchise in Kenya, and a cooperative in the Philippines. All programs empowered nurses to own, lead, and advance their professional influence. They had a social mission of improving access to care for disadvantaged populations, while increasing employment and autonomy of women. They also provided a shared platform for branding, purchasing, and quality assurance.
  
  
  CONCLUSIONS
  Organization sponsors in these models may be relevant to different actors in the United States. Each demonstrates the importance of a collective approach to advancing nursing enterprises.
authors.affiliation: Associate Professor, Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC. Electronic address: ppittman@gwu.edu.
authors.forename: Patricia
authors.initials: P
authors.lastname: Pittman
authors.affiliation: Professor, Department of Psychosocial and Community Health Nursing, School of Nursing, University of Washington, Seattle, WA; Professor, Department of Global Health, School of Public Heath, University of Washington, Seattle, WA.
authors.forename: Marla E
authors.initials: ME
authors.lastname: Salmon
mesh_terms: D003906:Developing Countries / Q000706:statistics & numerical data*; D004651:Employment; D005260:Female; D019513:Feminism; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007391:International Cooperation; D007630:Kenya; D019982:Organizational Case Studies; D009936:Organizational Innovation; D010067:Ownership / Q000458:organization & administration* / Q000706:statistics & numerical data; D010679:Philippines; D011209:Power, Psychological; D057184:Practice Patterns, Nurses' / Q000458:organization & administration* / Q000706:statistics & numerical data; D017149:Private Sector / Q000458:organization & administration* / Q000706:statistics & numerical data; D013636:Tanzania; D014481:United States
keywords: Access to care; Empowerment of women; Innovation; Nurses