Direct Request (CEACR) - adopted 2018, published 108th ILC session (2019)

Nursing Personnel Convention, 1977 (No. 149) - Guatemala (Ratification: 1995)

Article 2 of the Convention. National policy for nursing services and nursing personnel. The Committee notes the Government’s indication, in reply to its previous comments, that progress has been made, in the context of the implementation of the “Regional labour plan 2010–18” of the Central American Group of Nursing Professionals, with regard to the training of nursing personnel, and that a new “Regional plan 2018–20” is currently being drawn up. The Government indicates in general terms that the conditions of work of nursing personnel have improved and job opportunities in hospitals, health areas, health centres and private companies have increased. The Government adds that, with the aim of bringing health services closer to population groups that have limited access, the number of jobs for nursing personnel in health centres and health posts in rural areas has been increased, thereby creating new employment opportunities. In addition, various measures have been taken by the Ministry of Public Health and Social Assistance (MSPAS) to provide nursing personnel with appropriate education and training, such as updating the “Unified programme for the university level technical training for nurses” in 2015 in collaboration with national schools and private universities and with advisory support from the Pan American Health Organization (PAHO). The Government refers to the “National human resources development plan for the health sector 2007–15” and to the establishment of the College of Nursing Professionals, which has 760 registered members (80 per cent women, 20 per cent men). The Committee notes that the “General policy 2016–20” of the Government highlights the lack of funding in the health services in relation to gross domestic product (GDP) from previous years and the unequal distribution of human resources in the health sector. The policy document also indicates that most health-care teams were concentrated in the metropolitan area and adjoining departments and were not widely distributed among the economically and socially disadvantaged population groups requiring health services. The Committee also notes that, as a result, the top priorities of the abovementioned policy include health sector reform, the objectives of which include the training of personnel and the development of health sector careers. Lastly, the Committee notes that the Government does not provide information on the activities of the inter-institutional council, which was set up to find ways to curb the migration of qualified nursing personnel. The Committee requests the Government to provide information on the “Regional plan 2018–20” and the “National human resources development plan for the health sector 2007–15” with regard to nursing personnel, and on the implementation thereof. The Committee once again requests the Government to provide detailed, up-to-date information on the activities of the inter-institutional council. Moreover, the Committee requests the Government to provide detailed, up-to-date information on all other measures that have been adopted or planned, including those taken in the context of health sector reform, to provide nursing personnel with education and training appropriate to the exercise of their functions (Article 2(2)(a)). The Committee also requests the Government to provide information on measures taken or contemplated to ensure employment and working conditions, including career prospects and remuneration, which are likely to attract persons to the profession and retain them in it (Article 2(2)(b)). The Committee further requests the Government to provide information on consultations held with the employers’ and workers’ organizations concerned, where such organizations exist, with regard to the abovementioned measures (Article 2(3)).

Article 2(2)(b). Remuneration of nursing personnel. The Government indicates that the National Nursing Council is seeking to improve wages and professional recognition for nursing personnel. Such recognition has not been entirely possible for various reasons, especially the fact that there is no professional category for nursing in the manual of posts and wages, and so nursing graduates do not receive professional recognition. The Government adds that the process of reclassification of nursing posts and wages should enable progress to be made in this area. With regard to technical nursing personnel, the Government refers to the adoption of Government Decision No. 543-2013 of 30 December 2013 establishing the wage scale for paramedics. The Committee requests the Government to indicate the current status of the process of reclassification of wages for nursing personnel and to provide information on the outcome thereof.

Application in practice. The Committee observes that, according to statistical information supplied by the Government in its “General policy 2016–20”, as at 31 December 2015 there were 1,217 professional nurses and 5,690 contracted nursing assistants. In 2015, a total of 431 nursing assistants and 193 professional nurses accessed the profession. However, the Committee notes the Government’s indication that it does not have any statistical data on the number of nursing personnel who have emigrated to other countries in search of work. The Committee requests the Government to provide detailed, up-to-date information on the manner in which the Convention is applied in practice, including statistics on the numbers of nursing personnel – disaggregated by sex, sector of activity, level of training and functions – and also statistics on the nursing personnel/population ratio, the number of persons enrolling in nursing schools and the number of persons leaving the profession each year, and copies of official reports or studies relating to nursing services. The Committee also requests the Government to provide information on any practical difficulties encountered in the application of the Convention, such as the shortage or migration of nursing personnel.