South Africa’s dire shortage of nurses — estimated to be about 40000 in the public sector alone — is a priority for health minister Aaron Motsoaledi as he moves forward with the enormous task of improving SA’s health care system.
Motsoaledi, who says it is going to take 20 years to overhaul the public health system, plans to reopen 106 nursing colleges by June. This will double the number of nurses who can be trained in SA each year, from 2000 to 4000.
The drop in the number of nurses is put down to a misguided government decision 15 years ago to close nursing colleges and shift nursing training to universities. The result was that the number of nurses trained grew by only 1,8%/year while SA’s population grew by 23,2% to 49,9m people.
In the same period, management appointments in the public health service increased by almost 160%, according to a 2008 expenditure report by the health department.
The shortage of nurses will only get worse because 43,7% of registered professional nurses in SA are above the age of 50 and younger nurses are not being trained quickly enough to replace them when they retire.
The neglect of the nursing profession has been costly. SA has 383 nurses per 100000 people, or one nurse per 261 people, says economics consultancy Econex. In the US there are 980 nurses for every 100000 patients and in Australia 1090.
Motsoaledi feels government, not higher education institutions, should be responsible for nursing training.
It takes four years to train a professional nurse and one year to train an auxiliary nurse, which means the increased supply of newly trained nurses feeding into the system will be gradual.
Behind the predictable political rhetoric heard at the recent nursing summit there does appear a real intention on the part of government to address the failings of the public health system.
One area President Jacob Zuma highlighted was hospital management, which has ballooned (see table) without doing much to improve the health service.
Zuma said an audit of nursing colleges showed a pattern of poorly co-ordinated training over the years, with most nurses receiving training from universities and private colleges.
“We are not saying that we do not want our nurses to have university qualifications. But we believe that universities should be part of a range of our training platforms and not a primary mode of the production of nurses,” he said.
Democratic Nursing Organisation of SA (Denosa) spokesman Asanda Fongqo says a 21st- century nurse deals with more challenges than their colleagues did in the past.
“The decision to close nursing colleges was to the detriment of a sustained supply of nurses ,” he says.
“Nurses left because of poor service and poor salaries which were not in line with the increased demands of their work.”
He says a positive aspect to come out of the summit was the acknowledgement that training needed to be aligned with the challenges of the profession.
Prof Dudu Nzimande, a founding member of Denosa, is optimistic about plans to increase the number of nurses.
She says the waiting list of prospective students is long and low matric pass rates should not discourage people from the profession as auxiliary nurses are some of the most needed in the health-care system.
“We lost a lot of privileges in the nursing profession and that is the reason so many nurses left the country. I am encouraged by how many of them want to come home,” says Nzimande.
Motsoaledi seems determined to tackle the problems at the root of SA’s public health service. The new approach to the training of nurses is positive but it will be some time before the impact will be felt. Bringing more nurses to the wards is only one aspect of a much larger effort to make the health service work for all.
Motsoaledi, who says it is going to take 20 years to overhaul the public health system, plans to reopen 106 nursing colleges by June. This will double the number of nurses who can be trained in SA each year, from 2000 to 4000.
The drop in the number of nurses is put down to a misguided government decision 15 years ago to close nursing colleges and shift nursing training to universities. The result was that the number of nurses trained grew by only 1,8%/year while SA’s population grew by 23,2% to 49,9m people.
In the same period, management appointments in the public health service increased by almost 160%, according to a 2008 expenditure report by the health department.
The shortage of nurses will only get worse because 43,7% of registered professional nurses in SA are above the age of 50 and younger nurses are not being trained quickly enough to replace them when they retire.
The neglect of the nursing profession has been costly. SA has 383 nurses per 100000 people, or one nurse per 261 people, says economics consultancy Econex. In the US there are 980 nurses for every 100000 patients and in Australia 1090.
Motsoaledi feels government, not higher education institutions, should be responsible for nursing training.
It takes four years to train a professional nurse and one year to train an auxiliary nurse, which means the increased supply of newly trained nurses feeding into the system will be gradual.
Behind the predictable political rhetoric heard at the recent nursing summit there does appear a real intention on the part of government to address the failings of the public health system.
One area President Jacob Zuma highlighted was hospital management, which has ballooned (see table) without doing much to improve the health service.
Zuma said an audit of nursing colleges showed a pattern of poorly co-ordinated training over the years, with most nurses receiving training from universities and private colleges.
“We are not saying that we do not want our nurses to have university qualifications. But we believe that universities should be part of a range of our training platforms and not a primary mode of the production of nurses,” he said.
Democratic Nursing Organisation of SA (Denosa) spokesman Asanda Fongqo says a 21st- century nurse deals with more challenges than their colleagues did in the past.
“The decision to close nursing colleges was to the detriment of a sustained supply of nurses ,” he says.
“Nurses left because of poor service and poor salaries which were not in line with the increased demands of their work.”
He says a positive aspect to come out of the summit was the acknowledgement that training needed to be aligned with the challenges of the profession.
Prof Dudu Nzimande, a founding member of Denosa, is optimistic about plans to increase the number of nurses.
She says the waiting list of prospective students is long and low matric pass rates should not discourage people from the profession as auxiliary nurses are some of the most needed in the health-care system.
“We lost a lot of privileges in the nursing profession and that is the reason so many nurses left the country. I am encouraged by how many of them want to come home,” says Nzimande.
Motsoaledi seems determined to tackle the problems at the root of SA’s public health service. The new approach to the training of nurses is positive but it will be some time before the impact will be felt. Bringing more nurses to the wards is only one aspect of a much larger effort to make the health service work for all.
