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This chapter explores how several social, economic and cultural factors have shaped the present realities of nursing higher education programs. It illustrates how the interactions between national and international political and economic forces have determined policies for health services and public health, as well as the current nursing practice in Colombia. The chapter discusses the history of changes to nursing in Colombia and identify the current contradictions between the goals of nursing practice and those of nursing higher education. It examines the influences on Colombia’s university level programs in nursing health care, reviewing specifically the four factors by which Colombian education programs in nursing have historically been shaped. The chapter discusses the roles national and international forces–especially political and economic–have played in defining university nursing education policies and …