Direct Request (CEACR) - adopted 2005, published 95th ILC session (2006)

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

The Committee notes the Government’s report and wishes to draw its attention to the following points.

Article 2, paragraph 2(b), of the Convention. The Committee notes the Government’s explanations on the Additional Duty Hours Allowance and its method of calculation. The Committee understands that this allowance permits to increase the basic wage of a nurse from about 800,000 cedis (US$90) to 1.5 million cedis (US$170) and accordingly helps to retain many staff who would otherwise not resist calls from recruitment agencies to accept salaries up to 20 times higher abroad. At the same time, recent studies show that annual figures on Ghanaian nurses’ intention to migrate almost double the replacement rates from training while Ghanaian health workers in general (including doctors, pharmacists and laboratory technicians) show one of the highest levels of intention to migrate (61.6 per cent) in sub-Saharan Africa. Under the circumstances, the Committee considers that preserving its nursing workforce should be the Government’s primary goal in the field of health-care policy and therefore every possible step should be taken to address the concerns of nursing personnel, especially as regards adequate remuneration levels and motivating working conditions. The Committee asks the Government to closely monitor the evolution of the situation regarding health worker migration and to report on the impact any further incentive schemes may have on stemming the migration flow.

Article 3, paragraph 1. The Committee notes the information on the introduction of direct midwifery training and asks the Government to continue to provide information on measures relating to nursing education and training as may be taken in consultation with the Nurses and Midwives Council.

Article 5, paragraph 2. Recalling that the last time the Government provided copies of collective agreements applicable to nursing personnel was in 1992, the Committee requests the Government to transmit together with its next report copies of all collective bargaining agreements currently in effect and to specify the approximate number of health-care workers covered by those instruments.

Article 7. The Committee notes with interest the establishment by Act No. 613 of 2002, of the Ghana AIDS Commission (GAC) as a supra-ministerial and multi-sectoral body to coordinate programmes and activities of all stakeholders (ministries, departments, agencies, the private sector, development partners, NGOs, community-based organizations and civil society) in the fight against HIV/AIDS. It also notes that the heads of the Ghana Registered Nurses Association (GRNA) and the Ghana Registered Midwives Association (GRMA) are members of the Commission. The Committee requests the Government to supply additional information on the programmes and objectives of the GAC, including any specific initiative undertaken with respect to protection of nursing personnel from HIV infection.

Part V of the report form. The Committee notes that according to some accounts, nursing migration is intensifying and as a result more than 60 per cent of nursing positions remain unfilled even though nursing schools train about 600 nurses per year. As a 2002 report on the state of the Ghanaian economy indicated, 3,157 health workers left the country between 1993 and 2002, which represented over 31 per cent of health professionals trained in Ghana in the same period. The Committee is led to understand that at present there are only 10,000 nurses (as compared to over 20,000 nurses some 15 years ago) taking care of a population of about 19 million. The Committee would be grateful to the Government for supplying additional information on any concrete efforts to address the problem of a shortage of nurses, especially by adopting incentive measures to retain qualified professionals in the health sector. Moreover, the Committee would appreciate receiving all available information on the practical application of the Convention, including for instance statistics on the nurse-to-population ratio, the number of students attending nursing schools and the number of nurses leaving or joining the profession, copies of official reports or research studies examining the employment and working conditions of nursing personnel, etc.