In 1920, Henrietta Vinton Davis established the Black Cross Nurses (BCN) in Philadelphia as an auxiliary of the Universal Negro Improvement Association and African Communities League (UNIA).

Local chapters were established with a matron, head nurse, secretary and treasurer to provide health services and hygiene education to black members of the community.

[3] Few programs existed which would admit people of African descent into nursing training at the time and many health facilities provided unequal care to black patrons;[4] one of the goals of the organization was addressing these discrepancies.

[13] As an overriding goal, the organization used social health concerns to uplift the black race from degeneracy, believing that by creating a sanitary living environment, the community would prosper.

Marching practice was necessary as local chapters participated in parades on holidays such as Memorial Day and the Fourth of July,[24] sometimes carrying the Black Nationalist flag.

[26] Dr. K. Simon, medical officer for the Cayo District, moved to Belize Town in 1921, and began instructing members of the UNIA in midwifery, to combat the high mortality rates for infants and mothers.

An annual event called the Baby Exhibition, was a competition to award healthy infants in various age categories and display proper parenting to the populace.

It was a popular event which consolidated the public perception of the nurses as professionals, since they chose the contestants, and the approval of the government, since the colonial medical authorities determined the winners.

[26] On the one hand, they sought Victorian morality as a means to improve society as a whole and were rigidly opposed to the baser habits of the lower classes while on the other, they expanded women's spheres from within the confines of domesticity.

[32] In the attempt to maintain order, Seay's policies excluded poor and working-class women, while at the same time strengthening middle-class Creole political worth.

[34] It was the most active and lasting black organization in the country,[35] and though it lost momentum after Seay's death was revitalized in the 1980s and continues to serve the humanitarian needs of communities in which its members live.

[42] Approximately 25% of the black population of Canada joined the Universal Negro Improvement Association of Canada and a high percentage of those members were of West Indian heritage,[43] possibly due to the strong identification of people from the Caribbean with the British colour-class system: white rulers; brown, mixed-race middle class; and black, laboring lower class.