Though SA remains challenged by the shortage of health-care professionals there has been an improvement in the number of registered nurses.
Figures released by the SA Nursing Council (SANC) show 40% growth in the number of nurses registered over the past nine years to 248,736. Of those, qualified nurses and midwives increased from 96,715 to 124,045. The rest are enrolled nurses - nursing students who have completed one or two years of training.
The improvement has come despite the six-year moratorium on new private nursing colleges imposed by the SANC between 2004 and 2010, which the Democratic Alliance says contributed to the shortage of nurses, particularly specialists.
The council doesn't know exactly how many nurses are practising, because some may have taken non-clinical positions within the healthcare sector and others may have changed careers, but retained their registrations in case they want to practise again.
The improvement is a far cry from what the country needs for the roll-out of national health insurance (NHI). SA has 428 nurses per 100,000 people, says Dorothy Matebeni, president of the Democratic Nursing Organisation of SA. She says that compares poorly with countries such as Australia, which has 1090 nurses per 100,000 people.
According to the health department's new human resources strategy, presented just a few months before the launch of the green paper on the NHI, the state would need to hire about 83,000 additional healthcare professionals over the next 14 years, the bulk of them nurses.
The SANC's figures show that the nursing population is ageing, with about 45% of the workforce over 50. The HR strategy says that to sustain the ratio up to 51,200 nurses would have to be produced over the next 10 years to replace those retiring and leaving the profession. But the target is unlikely to be met given that SA produces only about 3,200 professional nurses a year.
Though the moratorium was lifted in June 2010, the SANC hasn't accredited any new colleges. Spokesman Party-Day Moloi says some applications have been declined because they don't comply with the new requirements while others are still being processed. One requirement is that applicants need to get letters of support from provincial departments of health, which must examine whether there's a need for a new college.
There has also been no word on when the 105 nursing colleges that President Jacob Zuma said were going to be revitalised would be operational. Health faculties in universities have been raising concerns, too, about lack of capacity to train new nurses.
Matebeni says a challenge faced by nursing colleges is a limited pool of educators, who must be qualified nurses. This threatens the quality of graduates.
"There's a critical shortage of nursing educators," says Matebeni. "We can open as many nursing colleges as we want, but we don't have educators. The tutors that colleges have are overwhelmed by the work."
Meanwhile, the SANC keeps postponing the implementation of new nursing qualifications in line with the National Qualifications Framework Act of 2008, which changed the previous eight NQF levels to 10 in line with international standards. The new date for the last intake of students in the current dispensation is now June 2015.
It's been over a year since regulations for the new qualifications were issued for public comment. Moloi says this was due to the consultation the council had to do. She says comment from the public has been received and the regulations will be gazetted soon.
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