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

Nursing Personnel Convention, 1977 (No. 149) - Congo (Ratification: 1986)

Article 2 of the Convention. Formulation of a national policy concerning nursing services and nursing personnel. The Committee notes the Government’s indications that the national policy concerning nursing services and nursing personnel is integrated into the National Health Plan (PNDS), established for the period 2007–11. It also notes that a consensus workshop, gathering together representatives of the Government, as well as representatives of international organizations, including the World Health Organization (WHO), was held in March 2010 to determine the main lines of the strategic human resources development plan for health. The Committee requests the Government to indicate the action taken to ensure consultation with the representatives of nursing personnel and their participation in the formulation of the strategic human resources development plan for health. The Committee also requests the Government to provide detailed information on the measures adopted to provide nursing personnel with education and training appropriate to the exercise of their functions and employment and working conditions which are likely to attract nursing personnel to the profession and retain them in it. The Committee also understands that the nursing sector in the country is currently facing problems of recruitment and the planning of nursing services, particularly in rural areas, due particularly to a shortage of qualified personnel. It therefore requests the Government to provide further information on the ratio between the numbers of nursing personnel and the number of inhabitants, and on the distribution of nursing personnel between urban centres and rural areas.

Article 3. Education and training of nursing personnel. The Committee notes that, according to the information published by the Africa Health Workforce Observatory in its Human Resources for Health Country Profile of March 2009, the paramedical schools responsible for training nursing personnel are currently facing many difficulties in providing courses, and that the nursing branch of the Health Sciences Faculty does not produce a sufficient number of graduates every year. The Committee requests the Government to provide fuller information on the extent of these problems, with an indication, based on statistical data, of the current and foreseeable effects of the insufficient numbers of young graduates in paramedical schools on the planning of nursing services, as well as the measures adopted or envisaged to remedy this situation.

Article 4. Requirements to practise nursing. The Committee requests the Government to provide a copy of Decree No. 88-430 of 6 June 1988 determining the requirements for the autonomous exercise of medicine and paramedical and pharmaceutical services. The Committee also notes that, according to the information contained in the report of the Africa Health Workforce Observatory referred to above, certain private training courses in the field of health are reported to have been established without the authorization of the Minister of Health and do not comply with the regulations in force. The Committee requests the Government to provide further information on this subject in its next report, with an indication of the measures adopted or envisaged to ensure that all private health structures comply with the requirements established by the laws and regulations.

Article 5. Participation of nursing personnel in the planning of nursing services. The Committee notes the Government’s indication that there is a legal void relating to collective disputes in the public sector. It requests the Government to provide further information on the machinery for the settlement of collective disputes in the sector and on the problems encountered in their implementation.

Article 6. Employment and working conditions of nursing personnel. The Committee notes that, according to the Government’s report, nursing personnel in the private sector are governed by the provisions of the Labour Code and by collective agreements and enterprise agreements. It requests the Government to provide copies of any relevant collective agreements and to indicate the manner in which it ensures that nursing personnel employed in the private sector enjoy working conditions at least equivalent to those of other workers, in accordance with Article 6 of the Convention. With regard to nursing personnel employed in the public sector, the Committee requests the Government to provide a copy of Decree No. 91-912bis of 21 December 1991 determining the specific conditions of service of employees of the Ministry of Health and Social Affairs and of the collective agreement of 1 September 1960 applicable to contractual employees.

The Committee however notes that, according to the report of the Africa Health Workforce Observatory referred to above, nursing personnel employed in the public sector have suffered a significant fall in their purchasing power in view of the reduction of their salaries by 17.5 per cent, which is resulting, among other effects, in absenteeism and the emigration of nursing personnel. The Committee recalls that, in accordance with Paragraph 25 of the Nursing Personnel Recommendation, 1977 (No. 157), the remuneration of nursing personnel should be fixed at levels which are commensurate with their socio-economic needs, qualifications, responsibilities, duties and experience, which take account of the constraints and hazards inherent in the profession, and which are likely to attract persons to the profession and retain them in it. The Committee requests the Government to indicate the measures adopted or envisaged to improve the terms and conditions of employment, and particularly the wage conditions, of nursing personnel.

Article 7. Adaptation of occupational health and safety measures to the special nature of nursing work. The Committee notes that, according to the Government’s report, ministries, as well as enterprises and establishments employing at least one worker, are required to establish units to combat HIV/AIDS. In this respect, the Committee wishes to draw the Government’s attention to the HIV and AIDS Recommendation, 2010 (No. 200), and particularly to Paragraph 31, which indicates that “Safety and health measures to prevent workers exposure to HIV at work should include universal precautions, accident and hazard prevention measures, such as organizational measures, engineering and work practice controls, personal protective equipment, as appropriate, environmental control measures and post exposure prophylaxis and other safety measures to minimize the risk of contracting HIV and tuberculosis, especially in occupations most at risk, including in the health care sector.” The Committee requests the Government to provide detailed information on the establishment and operation of these units, the results that are expected and obtained and on all safety measures adopted or envisaged for nursing personnel designed to limit to a maximum the risk of contracting HIV.

Part V of the report form. Application in practice. In its report the Government refers to difficulties in the implementation of the Convention related to the legal voids concerning the specific nature of the nursing profession. The Committee requests the Government to provide detailed information in its next report on these difficulties and on the measures adopted or envisaged to resolve them. It also requests the Government to provide updated information on the numbers of nursing personnel, the number of students in nursing schools and the number of members of nursing personnel arriving in the profession and leaving it. The Committee would also be grateful if the Government would indicate whether the trends observed throughout the world (lack of qualified nursing personnel, the departure of such personnel abroad, the privatization of health care establishments) are having quantitative and qualitative effects on the nursing care provided in the country and, if so, to describe these effects.