Direct Request (CEACR) - adopted 2013, published 103rd ILC session (2014)

Nursing Personnel Convention, 1977 (No. 149) - Zambia (Ratification: 1980)

Other comments on C149

Direct Request

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Article 2(2) of the Convention. National policy concerning nursing services and personnel. The Committee notes the Government’s reference to the latest National Human Resources for Health Strategic Plan (2011–15) which, among other issues, outlines specific strategies to contain migration of health-care workers. The Committee also notes the Government’s reference to the Zambian Health Workers Retention Scheme (ZHWRS), which was initiated to attract health-care personnel (doctors and, as from 2007, also nurses, laboratory technicians and midwives) to work in rural and remote areas mainly through various financial incentives. The award payments of the ZHWRS range from 30 to 75 per cent of the health-care worker’s basic salary per year based on the remoteness of the health facility in which the worker is placed, while workers on the ZHWRS who successfully complete the three-year contract are awarded a bonus payment of an amount nine times their monthly allowance. The Committee understands, however, that despite this effort the critical shortage of health workers remains a source of grave concern for public authorities. According to recent studies, there is currently a shortage of 27,000 health workers, including 10,387 registered nurses, while the staff-to-population ratio is one nurse per 1,800 people, well below the country’s desired minimum of one health worker per 400 people. Noting that the dire health worker shortage – principally due to external brain drain but also internal migration – is an ongoing challenge to the Ministry of Health, the Committee requests the Government to continue to provide up-to-date information on the implementation of the strategic plan for human resources for health, in particular, as regards efforts to address the health worker shortage and the results achieved.