Direct Request (CEACR) - adopted 2008, published 98th ILC session (2009)

The Committee notes that the Government’s report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which read as follows:

Article 2, paragraph 2(b), and Article 5, paragraph 2, of the Convention. The Committee wishes to receive the Government’s views as to whether the wages practised in the nursing sector adequately reflect the socio-economic needs, special responsibilities and inherent risks of the nursing profession and also whether current pay conditions are likely to ensure sufficient recruitment of qualified health professionals. Moreover, the Committee has been requesting the Government, for a number of years, to transmit a copy of the revised terms and conditions of employment applicable to members of the Christian Hospitals’ Association of Malawi (CHAM). Despite the Government’s assurances that this document would be made available through the UNDP, no such copy has ever been received by the Office. The Committee therefore requests the Government to provide, together with its next report, fully documented information on the working conditions (including working time, occupational health protection and social security) of nurses in the private sector. Furthermore, while noting the Government’s statement that the nurses and midwives associations of Malawi are the two organizations which look into the working conditions of nursing personnel, the Committee asks the Government to provide more specific information on the process of unionization of nursing staff and to indicate any progress made towards the determination of conditions of employment and work through collective bargaining.

Article 3, paragraph 1. The Committee notes that, in accordance with sections 3 and 11 of the Nurses and Midwives Act, 1995, the Nurses and Midwives Council of Malawi (NMCM) is charged with overseeing nursing and midwifery education, professional practice and conduct. The Committee would appreciate receiving additional information on all the policies and programmes recently initiated by the NMCM, such as the electronic nursing registry which is now in place within the registration section of the NMCM and which has the capacity to monitor nurse and midwife registration, licensure and deployment. The Committee would also be interested in obtaining up-to-date information on the activities of the NMCM, through its Education and Examination Committee, in matters of approval of nursing schools, curricula and qualifications pursuant to section 47(1) of the Nurses and Midwives Act.

Part V of the report form. The Committee notes that, according to a communication of the Malawi Congress of Trade Unions (MCTU) received on 5 April 2005, there is a brain drain in the nursing profession because of lack of motivation, and the Government has not put in place measures to stop this trend. In its reply dated 16 September 2005, the Government indicates that it has been working very hard to motivate employees in the health profession, in particular by raising their salaries by 52 per cent as from April 2005, and regrets not having received any concrete suggestions from the MCTU on the issue of brain drain. The Committee understands that the Ministry of Health and Population has been working since 2002 on an Essential Health Package (EHP) to address current inefficiencies in the public health sector and improve the quality of publicly funded health services. In this connection, the Committee notes that under the EHP Implementation Plan, an estimated 8,273 additional nursing personnel are required at the community, health centre and hospital levels. With regard to the problem of brain drain, the Committee understands that nurses who wish to leave the country must register with the Nurses and Midwives Council of Malawi. According to the information available to the Committee, 614 nurses, 95 per cent of whom have a university degree, have registered for this purpose since 2000. It notes, however, that the number of registrations per year is falling, from 111 in 2001 to 98 in 2005 and 23 in 2007.

The Committee would be grateful if the Government would supply in its next report detailed information on any progress made towards the implementation of the EHP proposals, especially as regards the shortage of nursing staff, as well as all other available information on the practical application of the Convention, including, for instance, statistics on the nurse-to-population ratio, the number of students attending nursing schools, the number of nurses leaving or joining the profession per year, copies of official reports or research studies examining the employment and working conditions of nursing personnel, etc.