Direct Request (CEACR) - adopted 2009, published 99th ILC session (2010)

Nursing Personnel Convention, 1977 (No. 149) - United Republic of Tanzania (Ratification: 1983)

Article 2 of the Convention. National policy on nursing services and nursing personnel. With regard to the Government’s earlier indication that a new edition of the 2002 National Nursing and Midwifery Policy Guidelines was due for review to reflect ongoing changes in the health sector, the Committee notes that the Government’s report does not provide any further details on the review process or its possible outcome. The Committee therefore requests the Government to provide up to date information on national health-care policy, including measures taken or envisaged to facilitate the effective utilization of nursing personnel in the country and to promote the fullest use of the qualifications of nursing personnel in the various health-care establishments. It also requests the Government to provide more detailed information on the institutional framework within which the representative organizations of nursing personnel are consulted with respect to the elaboration and application of policies and principles regarding the nursing profession and the determination of conditions of employment and work of nursing personnel. Finally, the Committee would thank the Government for transmitting a copy of the latest edition of the National Nursing and Midwifery Policy Guidelines.

Article 3. Education and training. The Committee notes the Government’s explanations on the admission requirements, educational programmes and specialties offered in the field of nursing and midwifery. The Committee would be grateful if the Government would continue to provide information on the duration and levels of nursing education and training, the nursing personnel structure (e.g. professional nurses, auxiliary nurses and nursing aides) established by reference to education and training, specific programmes for continuing nursing education and skill advancement as well as any other activity, programme or initiative aimed at improving the quality standards of nursing education and training.

Article 5. Consultations with representative organizations of nursing personnel. The Committee notes the Government’s statement that it is doing every possible effort to improve working terms and conditions for nursing personnel. The Government also indicates that apart from the Tanzania National Nurses Association (TANNA), the Tanzania Union for Government and Health Employees (TUGHE) was very much involved in the health sector wage board for the purpose of fixing minimum wage rates for health employees. The Committee once again requests the Government to transmit copies of any collective agreement currently in force in the health-care sector or of any regulatory text, such as wage board decisions, that may have been the result of consultations with representative organizations of nursing personnel.

Article 6. Working conditions of nursing personnel. The Committee notes the Government’s reference to the Employment and Labour Relations Act, 2004, and the Social Security (Regulatory Authority) Act, 2008, which apply to all employees both in the public and private sectors. The Committee recalls that the specificity of nursing services often calls for particular working time arrangements and results in rather uncommon work organization and consequently working conditions. The Committee refers, in this connection, to Paragraphs 30–43 of the Nursing Personnel Recommendation, 1977 (No. 157), which offer some guidance on this point. The Committee would therefore be interested in receiving detailed information, including copies of any relevant legal texts not previously communicated, concerning the specific conditions applicable to nursing personnel relating to shift work, overtime, inconvenient hours, rest periods or any other aspect of employment regulated in a manner distinctly different from other workers.

Article 7. Occupational health and safety of nursing personnel. The Committee notes that nurses and midwives guidelines and practice protocols for prevention of HIV/AIDS infection from needle stick and sharp objects have been developed while training is provided on matters such as reporting needle stick injuries, exposure from infectious materials, and health-care facilities to provide post-exposure prophylaxis (PEP). The Committee requests the Government to keep the Office informed of all relevant developments in this respect. It would also appreciate receiving a copy of the guidelines and practice protocols for HIV/AIDS prevention referred to in the Government’s report.

In this respect, 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 refer to the International Labour Conference discussion held in June 2009 on “HIV/AIDS and the world of work”, with a view to adopting an international labour Recommendation, and in particular to paragraph 37 of the proposed conclusions (see ILC, 98th Session, 2009, Report IV(2), page 310) which provides that public health systems should be strengthened, where appropriate, in order to ensure greater access to prevention, treatment, care and support, and to reduce the additional strain on public services, particularly on health workers, caused by HIV/AIDS.

Part V of the report form. Application in practice. The Committee notes that according to the statistical information provided by the Government in its report, there are currently 22,217 registered nurses of whom 2,217 are men and 20,000 are women. It also notes the data on schools offering nursing studies and that on average 1,750 students are enrolled per year in the certificate, 560 in the diploma, and 77 in the advanced diploma programme. The Committee would appreciate if the Government would continue supplying up to date information on the practical application of the Convention, both in continental Tanzania and in Zanzibar, for instance, statistical data and characteristics of the composition of the nursing workforce (e.g. age, gender), the number of nurses exiting or joining the profession every year, the nurse-to-population ratio, copies of official reports or studies addressing nursing-related issues, any practical difficulties experienced in the application of the Convention, such as shortage or migration of qualified nurses, etc.