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

Nursing Personnel Convention, 1977 (No. 149) - Seychelles (Ratification: 1993)

Article 2, paragraph 1, and Article 3 of the Convention. Policy concerning nursing services and personnel. The Committee notes the Government’s statement that at present workers’ organizations are not consulted on policy issues, but in future certain health policies could be formulated in conjunction with the employers’ and workers’ organizations concerned. Recalling similar assurances given by the Government in its previous report, the Committee hopes that the Government will make every effort to associate the social partners in designing and implementing all future policies concerning nursing services and personnel, as prescribed by this Article of the Convention.

Moreover, the Committee notes the Government’s statement that there is regular attrition of nurses who leave the country in the search of better employment opportunities abroad. While noting that the statistical data provided by the Government show that the number of nurses and midwives has remained stable in public institutions in the period 2002–07, the Committee would appreciate receiving fuller information on the situation concerning nurse migration and the efforts of the Government to maintain a sustainable domestic nurse workforce.

In this respect, the Committee wishes to refer to the commonwealth code of practice for the international recruitment of health workers and its companion document, adopted in 2003. In particular, it notes that the code provides that the international recruitment of health workers must be transparent and fair as regards its process, and that the right of health workers to migrate must not be undermined. At the same time, such recruitment must be mutually beneficial to both recruiting and source countries considering the difference in the capacities of these countries, which may be addressed through technical assistance. In the same vein, the Committee notes the draft WHO code of practice on the international recruitment of health personnel, currently under consideration, which urges member States to enter into bilateral and multilateral arrangements to promote cooperation and coordination on migrant health personnel recruitment processes in order to maximize the benefits and mitigate the potential negative impact of international recruitment of health personnel, and also calls for measures in order to retain and sustain a skilled domestic health workforce by improving their social and economic status, their living and working conditions, their opportunities for employment and their career prospects.

Articles 3 and 4. Nursing education and training. The Committee notes the Government’s indication that a new nursing curriculum has been prepared taking into consideration regional and international nursing standards. The Committee requests the Government to provide more detailed information on the new programme.

Article 7. Regulations on occupational health and safety for nursing personnel. Further to its previous comment on this point, the Committee understands that the National AIDS Council adopted in 2007 the “Seychelles Policy on HIV/AIDS in the Workplace”. In particular, it notes that the policy emphasizes the importance of the principles of tripartism and social dialogue in approaching matters related to HIV/AIDS as workplace issues, and the shared responsibility of employers and workers for ensuring a healthy work environment, including safety from HIV contamination. The Committee requests the Government to provide additional information on any specific policies or measures for nursing personnel, given the particular risk they face due to the nature of their work, as well as the implementation of the “Management of health-care worker exposures to HIV and recommendations for post-exposure prophylaxis”, and the results obtained.

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.

Finally, the Committee notes that the Government’s report does not contain replies to certain points raised in its previous direct request. It is therefore bound to ask the Government to respond to the comments concerning the application of Article 2(2) (adoption of regulations on education and training requirements in nursing and midwifery under the Nurses and Midwives Act); Article 2(3) (consultations with the social partners in formulation of health care policy); and Article 5 (representation of nursing personnel at the Central Management Committee of the Ministry of Health, collective bargaining in the nursing sector and settlement procedures for collective disputes).

Part V of the report form. Application in practice. The Committee notes the statistical information provided by the Government showing the number of nursing personnel registered with the Seychelles Nurses and Midwives Council and the evolution of number of health personnel employed at government establishments. It would be grateful if the Government would continue supplying up to date information concerning the application of the Convention in practice, including, for instance, statistics on the number of nurses entering and leaving the profession per year, the nurse–population ratio, copies of official reports or studies addressing nursing-related issues, any practical difficulties encountered in applying the Convention, etc.