Direct Request (CEACR) - adopted 2011, published 101st ILC session (2012)

Nursing Personnel Convention, 1977 (No. 149) - Kenya (Ratification: 1990)

Other comments on C149

Direct Request

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Article 2(2) of the Convention. Measures to promote attractive employment and working conditions for nursing personnel. The Committee notes the revised Scheme of Service for Nursing Officers, issued in August 2002, which provides for a well-defined career structure (establishing eight grades of nursing officers) for qualified nursing personnel in the public sector. With respect to the remuneration levels, the Committee notes the Government’s indication that wages for nursing personnel have gone up by between 90 and 116 per cent during the period from 2000 to 2008. The Committee also notes the general information provided by the Government concerning measures to monitor the nursing workforce and facilitate retention, for instance the setting up of a comprehensive electronic database of nurses, doctors, clinical officers and laboratory staff deployed in various health facilities, and the increase of the retirement age from 55 to 60 years that resulted in the retention of 2,500 nurses who could otherwise have been retired between 2009 and 2013. Moreover, the Committee notes the Second National Health Sector Strategic Plan (NHSSP II) of the Ministry of Health for the period 2005–10 which identifies human resource management issues such as insufficient staffing at most health centres and dispensaries and the need for redeployment of nurses. The Committee understands that a first Strategic Plan for the nursing sector has been drafted and also that new draft legislation on nursing personnel is currently before the Parliament. The Committee requests the Government to keep the Office informed of any progress made in the adoption of these legislative and policy measures and to transmit copies of all relevant texts once they have been adopted.

As regards the issue of ongoing migration of nursing personnel, the Committee notes the Government’s indication that strategies are being discussed to address the issue, including measures such as the payment of an extra allowance, salary increment and constant dialogue. In this connection, the Committee draws the Government’s attention to the draft WHO Code of Practice on the International Recruitment of Health Personnel, currently under preparation, which urges member States to enter into bilateral and multilateral arrangements to promote cooperation and coordination on migrant health personnel recruitment processes in order to maximize the benefits and mitigate the potential negative impact of international recruitment of health personnel, and also calls for measures in order to retain and sustain a skilled domestic health workforce by improving their social and economic status, their living and working conditions, their opportunities for employment and their career prospects. The Committee requests the Government to keep the Office informed of any specific measures taken or envisaged with a view to controlling or mitigating the consequences of the continued migration of qualified nurses.

Article 3(1). Nursing education and training. The Committee notes the Government’s indication that training opportunities for nurses have considerably expanded with only two universities offering degree programmes in nursing in 2002, as compared to ten universities delivering first and second degree programmes today. The Government adds that, in total, there are 68 training institutions for nurses at the certificate, diploma and degree levels. In view of the rapid growth in the number of institutions offering nursing education and training, the Committee requests the Government to provide more detailed information on the organization of nursing studies (requirements for entry, levels of education, duration), the coordination with educational programmes designed for other health workers, and the supervision of nursing education and training by the public authorities.

Article 5(2). Determination of conditions of employment and work. The Committee recalls its previous comments in which it requested the Government to provide copies of all collective agreements currently in effect regulating the conditions of employment and work of health-care personnel in the private sector. In the absence of the Government’s reply on this point, the Committee again requests the Government to: (i) specify how it is ensured that the terms and conditions of employment applicable to nurses in the private sector are determined through negotiation between employers’ and workers’ organizations; and (ii) transmit copies of relevant collective agreements.

Article 7. Occupational health and safety. The Committee notes the Government’s indication that efforts are being made to improve safety at workplace with specific focus on infection prevention and needle stick injuries. The Government also indicates that nurses continue to receive on-the-job training in modern infection prevention and post-exposure prophylaxis while infection prevention guidelines are under preparation. Moreover, the Government has transmitted a copy of the revised Public Sector Workplace Policy on HIV and AIDS, which was published by the Ministry for Public Service in May 2010 with a view to addressing new challenges and emerging issues in the management of HIV and AIDS. In this connection, the Committee draws the Government’s attention to the Joint ILO/WHO guidelines on health services and HIV/AIDS, published in 2005, with a view to assisting health services in building their capacities to provide their workers with a safe, healthy and decent working environment as the most effective way both to reduce transmission of HIV and to improve the delivery of care to patients. The Committee wishes also to draw the Government’s attention to the new HIV and AIDS Recommendation, 2010 (No. 200), paragraph 45 of which provides that public health systems should be strengthened to help ensure greater access to prevention, treatment, care and support, and reduce the additional strain on public services, particularly on health workers, caused by HIV and AIDS. The Committee requests the Government to transmit a copy of the infection prevention guidelines once published. It also requests the Government to keep the Office informed of any initiatives or programmes to improve the occupational safety and health of nursing personnel, especially the protection against infectious diseases such as HIV/AIDS, in view of the specific risks and hazards inherent in the profession.

Part V of the report form. Practical application. The Committee notes the statistical information provided by the Government showing that the nursing personnel represents over 47 per cent of the workforce in the health sector. The Committee requests the Government to continue to provide the information concerning the application of the Convention in practice, including, for instance, the number of students attending or graduating nursing schools every year, the number of practising nurses registered with the Nursing Council of Kenya, the nurse-population ratio, and copies of any recent reports or studies addressing nursing-related issues.