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This resource is hosted by the Nelson Mandela Foundation, but was compiled and authored by Padraig O’Malley. It is the product of almost two decades of research and includes analyses, chronologies, historical documents, and interviews from the apartheid and post-apartheid eras.

Crisis as SA steadily loses qualified nurses

Bruce Venter
2005-01-14

A critical shortage of nurses is developing in South Africa - just when the need for them is desperate.

The growing population and expected increases in communicable diseases will mean that the role of trained nurses - in hospitals and primary healthcare facilities - will become increasingly vital.

But far from more people coming forward to be trained, a Human Sciences Research Council (HSRC) study shows that South Africa is steadily losing trained nursing staff.

Situation is far worse than study shows

Statistics SA said that in 2002 the country boasted 155 484 practising nurses, giving a nurse/population ratio of 343 per 100 000 - favourable when compared to the World Health Organisation's minimum of 200 per 100 000.

However, there has been a steady fall over the past decade in enrolments for nursing studies.

The HSRC study shows that between 1990 and 2000 nursing qualifications decreased by 1,2 percent, with new entrants into the profession decreasing by almost one percent.

The study also finds that more than 18 percent of nurses registered with the SA Nursing Council are 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.

The exact figures for nurses lost to emigration are not known, but more than 700 are officially recorded as having left the country since 1995.

A 2003 HSRC study found almost 80 percent of nurses experienced increased workloads, with 60 percent dissatisfied with their working environments.

Nurses in provinces with large rural populations are particularly vulnerable. They tend to be more at risk because of the disproportionate distribution of nurses in the country.

Gauteng enjoys a nurse/population ratio of 412:100 000 and the Free State 419:100 000.

Limpopo, Mpumalanga, Northern and Eastern Cape reflect ratios well below the national 343:100 000 average.

However, the Democratic Nursing Organisation of SA has said the situation was far worse than the HSRC study suggested.

Spokesperson Nelouise Geyer said the reported nurse-to-population ratio was not representative of true circumstances in hospitals.

That figure reflects the number of nurses currently available. It does not reflect the actual number of nurses physically dealing with patients at the bedside.

The true ratio was much lower than the official figure, according to Geyer.

The base of specialised nurses is rapidly thinning out... there is not a sufficient pool of experienced nurses from which replacements can be drawn.

Geyer also questioned the figure quoted for the number of practising nurses.

Nurses working on short-term overseas contracts tend to keep their licences current so that they can be employed on their return, she said.

Dr Percy Mahlati of the department of health said shortages shouldn't be seen in isolation but as part of a greater human resources challenge.

There are currently about 32 000 vacant nursing posts in the country's public hospitals. (Source: The Star, January 14, 2005)

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