South Africa

January 2005

  
Nursing staff crisis looms, (Pretoria News, 2005-01-17):-A critical shortage of nurses is developing in South Africa - at a time when the need for them is desperate. The growing population and expected increases in communicable diseases will mean that the role of trained nurses -operating both in hospitals and primary health care facilities - will become increasingly vital. But far from more people coming forward to be trained in this field, a Human Sciences Research Council (HSRC) study has shown that South Africa is steadily losing trained nursing staff. Statistics South Africa said in 2002 the country boasted 155 484 practising nurses, giving a nurse/population ratio of 343:100 000, which is favourable when compared to the World Health Organisation minimum of 200:100 000. The base of specialsed nurses is rapidly thinning out ... there is not a experienced nurses from which replacements can be drawn". However, there has been a steady fall over the past decade in enrolments for nursing studies. The HSRC study showed that between 1990 and 2000, nursing qualifications decreased by 1,2%, with new entrants into the profession decreasing by almost 1%. The study also found that more than 18% of nurses registered with the South African Nursing Council were no longer practising. Reasons for the decline are varied, the study says, with emigration, work pressure and work environment-related factors among the main reasons leading to nursing skills losses. Exact figures for nurses lost by emigration are not known, but over 700 are officially recorded as having left the country since 1995. A 2003 HSRC study found almost 80% of nurses experienced increased workloads, with 60% indicating dissatisfaction with their working environments. Nurses in provinces with large rural populations are particularly vulnerable and tend to be more at risk of the above factors due to the disproportionate distribution of nurses in the country. Gauteng and the Free State enjoy a nurse/population ratio of 412:100 000 and 419:100 000 respectively. Limpopo, Mpumalanga, Northern and Eastern Cape reflect ratios are well below the current national average of 343:100 000. The Democratic Nursing Organisation of South Africa said the situation was far worse than the HSRC study suggested. Spokesman Nelouise Geyer said the reported nurse/population ratio was not representative of the true circumstances in the country's hospitals. "That figure only reflects the number of nurses currently available." "It does not reflect the actual number of nurses physically dealing with patients at the bedside," said Geyer. She said the true ratio was much lower than projected. "The base of specialised nurses is rapidly thinning out. There is not a sufficient pool of experienced nurses from which replacements can be drawn," said Geyer. Geyer also questioned the figure quoted for the number of practising nurses in the country. "Nurses working on short-term overseas contracts tend to keep their South African licences current so they can be employed on their return," said Geyer. These nurses were possibly included in the "practising" figure, said Geyer. Geyer said that with more career options available to women, the nursing profession's previous popularity had waned. Dr Percy Mahlati of the Department of Health says shortages must not be seen in isolation, but as part of a greater human resources challenge. There are presently about 32 000 vacant nursing posts in the country's public hospitals. "The issue is a holistic one, taking into account the prevalent factors that have led to the decrease in trained nurses," said Mahlati. He said the Department of Health was in the process of developing a broad human resources plan to address staff shortages throughout the public health sector. "The Department of Health is in discussions with all health stakeholders to resolve the issue," he said. Mahlati said emigration, working conditions and the remuneration policy for nurses were among the concerns to be addressed.  
South African Migration Project (SAMP) - Queen's University - http://www.queensu.ca/samp