Sunday Times

Skilled nurse short­age could hob­ble im­ple­men­ta­tion of na­tional health plan

- By PENELOPE MASHEGO Health · Medicine · Society · Iceland · Belgium · Austria · United Nations · World Health Organization · Belarus · National Health Insurance · University of the Witwatersrand · Mediclinic International · Netcare

● With the fi­nal im­ple­men­ta­tion of Na­tional Health In­sur­ance (NHI) fast ap­proach­ing, the need for skilled nurses is in sharp fo­cus and there is un­cer­tainty on whether SA will be able to fill the gap in time.

Dr Sue Arm­strong, a se­nior nurs­ing lec­turer at Wits Univer­sity, told del­e­gates to the Hos­pi­tal As­so­ci­a­tion of SA con­fer­ence on Tues­day that NHI re­quired a func­tional dis­trict health-care sys­tem to be ef­fec­tive. This was be­cause pre­ven­tion, early de­tec­tion and dis­ease treat­ment were done in dis­trict health sys­tems, which would not run ef­fec­tively with­out the re­quired num­ber of nurses.

“The ma­jor con­cern is that the pro­fes­sional nurses are an age­ing group. If one takes pop­u­la­tion growth into con­sid­er­a­tion, not as many pro­fes­sional nurses are cur­rently be­ing trained as are re­tir­ing,” she said.

At the heart of the prob­lem is that there has been a de­lay in South African Nurs­ing Coun­cil (SANC) ap­provals for pri­vate nurs­ing ed­u­ca­tion in­sti­tu­tions.

The gov­ern­ment trains 73% of SA’s nurses through its col­leges, but this is not enough to re­solve the short­age.

“Also, the train­ing of en­rolled nurses and nurs­ing aux­il­iaries has been stopped with­out hav­ing in place pro­vi­sion for train­ing of nurses in the new qual­i­fi­ca­tions, which has led to the de­cline in over­all nurse num­bers,” said Arm­strong.

En­rolled nurses pro­vide lim­ited nurs­ing care, while en­rolled nurs­ing aux­il­iaries per­form ba­sic pro­ce­dures and pro­vide gen­eral care for pa­tients. Both these types of nurses are su­per­vised by regis­tered nurses who also have their own nurs­ing du­ties.

She said SA sur­passes the UN’s sus­tain­able de­vel­op­ment goal (SDG) of 4.45 health pro­fes­sion­als to 1,000 peo­ple, at 5.1.

How­ever, the World Health Or­gan­i­sa­tion found that coun­tries that pro­vide the best qual­ity care have an av­er­age of 8.6 nurses to 1,000 peo­ple. Arm­strong be­lieves SA should meet that ra­tio for NHI to be a suc­cess.

“If noth­ing is done to rem­edy this sit­u­a­tion, the num­ber of nurses per pop­u­la­tion will fall be­low the SDG re­quire­ments by 2022,” she said.

Pri­vate hos­pi­tals, in­clud­ing Medi­clinic, Net­care and Life Health­care, have com­mit­ted to train­ing 50,000 new nurses through the Hos­pi­tal As­so­ci­a­tion of SA. But if pri­vate hos­pi­tals and in­sti­tu­tions man­age to start train­ing nurses only in 2022, it would take SA un­til 2059 to meet the SDG goals. The is­sue has been ex­ac­er­bated by the clo­sure of some nurs­ing col­leges in the 1990s to en­sure racial in­te­gra­tion in nurs­ing ed­u­ca­tion.

SANC did not re­spond to re­quests for com­ment.

 ?? Pic­ture: Mark An­drews ?? Train­ing enough nurses is cru­cial to the suc­cess of NHI.
Pic­ture: Mark An­drews Train­ing enough nurses is cru­cial to the suc­cess of NHI.

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