The East, Central, and Southern College of Nursing and Midwifery (ECSACONM) was established in 1990 as an executing arm of the then Commonwealth Regional Health Community Secretariat for East, Central and Southern Africa (CRHCS-ECSA) in the area of nursing and midwifery. The Arusha-based CRHC-ECSA secretariat which is now referred as ECSA Health Community (ECSA HC) brings together 14 regional states.

The member states are Botswana, Kenya, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. 

ECSA Health Community mandate is to promote and encourage efficiency and relevance in the provision of health-related services in the region, while its mission is to promote the highest standards of health for individuals, families and communities in the ECSA region.

As an executing arm of the ECSA Health Community, ECSACONM is charged with the responsibility of Promoting and strengthening professional excellence in nursing and midwifery in the ECSA region.

The underlying principles that led to the formation of ECSACONM, A College Without Walls, include:
- Harmonization of nursing and midwifery standards,
- Improvement of the nursing and midwifery professions,
- Creation of regional uniformity in the Nurses Acts,
- Clear definition of the nurses and midwives roles
- Strengthening of nursing and midwifery research activities.