| Summary: | In 2006, the Caribbean Community (CARICOM) – a federation of sovereign Caribbean states – decided that the Bachelor of Science in nursing degree would be the standard qualification for entry to nursing practice in its English-speaking member countries. Indications were that by 2011 all of the English-speaking states had not implemented the regional policy. This research study was conducted to reveal the origin and nature of the 2006 CARICOM nursing education reform, trace its pattern of implementation, and determine the implications of that pattern for the coverage and coherence of healthcare in the region. An interpretive study with a multiple case design was conducted. Six case units were investigated through a staged approach to this empirical study. The research drew on the findings of interviews with selected policy actors, and on findings from the review of relevant documentary sources. The main findings were that the reform was not fully adopted in the region; that system tensions delayed its implementation; and that country-specific factors produced the variation in its adoption by member states. These findings have implications for the harmonization of nursing across CARICOM and, by extension, for CARICOM’s functional cooperation in nursing services. They also have implications for the region’s accomplishment of the World Health Organisation’s objective of universal access to quality healthcare – part of its Universal Health Coverage by the year 2030 agenda. The results should be useful to Caribbean and international health and education policy scholars and actors.
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