Nursing Personnel Convention, 1977 (No. 149) - Ukraine (Ratification: 1979)

Direct Request (CEACR) - adopted 2019, published 109th ILC session (2021)

Articles 2(1) and 5(1) of the Convention. National policy concerning nursing services and nursing personnel. Consultations. In response to the Committee’s previous comments, the Government once again indicates that it is considering amending Ministry of Health Order No. 163 of 24 March 2006, which established the Coordinating Council for the Development of Nursing, with a view to further improving the quality of nursing care in the country. The Committee once again requests that the Government keep the Office informed of developments in relation to the possible amendment of Ministry of Health Order No. 163, and to provide information on consultations held with the social partners, particularly with representative workers’ organizations, such as the Ukrainian Nurses Association, in relation to the formulation of relevant policies, or the establishment of new structures or programmes that might have an impact on the employment and working conditions of nursing personnel.

Application in practice. Part V of the Report Form. The Committee recalls its previous direct request, in which it noted that the Government continued to experience difficulties in relation to the migration of qualified nurses who leave the country primarily due to low salaries and the lack of possibilities for professional development. It had requested the Government to provide information on measures taken to address this issue, as well as to provide available statistics concerning the current situation. The Committee notes the information provided by the Government on the number of nurses registered as unemployed and the number of nursing vacancies for the period from 2013 to 2017. As of 2017, there were 17,200 nurses registered as unemployed and 22,200 nursing vacancies registered with the State Employment Service (SES), of which 80 per cent were subsequently filled. The Government adds that, as of 1 January 2018, there were 5,200 nurses registered as unemployed, and there were 1,100 nursing vacancies. The Committee requests the Government to provide updated detailed information, disaggregated by age, sex and region, concerning the situation of nursing personnel in the country, including the number of graduates who enter the nursing profession each year, the number of nursing personnel broken down by those working at public and private healthcare establishments, and the number of those who leave the profession each year. The Committee also reiterates its request that the Government provide information concerning measures taken or envisaged with a view to containing or reversing the migration flow of qualified nurses, such as, for example, financial incentives or enhanced career prospects, which are likely to attract persons to the profession and retain them (Article 2 of the Convention).

Direct Request (CEACR) - adopted 2013, published 103rd ILC session (2014)

Articles 2(1) and 5(1) of the Convention. National policy concerning nursing services and nursing personnel. Further to its previous comment, the Committee notes the Government’s indication that it is considering amending the Ministry of Health Order No. 24 March 2006, which set up the Coordinating Council for the Development of Nursing with a view to further improving the quality of nursing care in the country. The Committee requests the Government to keep the Office informed of any further developments in this regard, and to specify whether representative workers’ organizations such as the Ukrainian Nurses Association were effectively consulted in the formulation of any new policy, or the setting up of new structures or programmes which might impact on the employment and working conditions of nursing personnel.

In addition, the Committee understands that the Government continues to experience difficulties regarding the migration of qualified nurses who leave the country mainly due to low salaries and the lack of possibilities for professional development. Ukraine is often listed among the top five countries in nurse migration, the most preferred destinations being Germany, Israel, Italy and Canada. The Committee requests the Government to provide in its next report up-to-date information, including all available statistics, concerning the current situation and any measures (for instance, financial incentives) to contain or reverse the migration flow of health professionals.

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

Article 2, paragraph 1, and Article 5, paragraph 1, of the Convention. National policy on nursing services and nursing personnel. The Committee notes the Government’s indication that a Coordinating Council for the Development of Nursing has been set up by the Ministry of Health in collaboration with the newly established Ukrainian Nurses Association. It also notes that the Ukrainian Nurses Association is one of the largest public associations bringing together over 84,000 nurses. The Committee requests the Government to elaborate on the composition and activities of the Coordinating Council, in particular as regards the formulation of a specific policy concerning nursing services and nursing personnel. It would also appreciate receiving up to date information on the implementation of the ten-year Programme for the Development of Nursing personnel (2002–2011) to which reference was made in the Government’s previous report.

Article 3. Nursing education and training. The Committee notes the Government’s indications about the 122 educational institutions offering nursing studies, the introduction for the first time of a Master’s degree in nursing and the increase of the duration of nursing training by one year in order to raise the level of training in accordance with international standards. It also notes the information about recent events and projects, such as the 2007 first Congress on the Development of Nursing and the 2007 joint Ukrainian–Dutch project MATRA for the improvement of nursing care and assistance for the elderly. The Committee would appreciate if the Government would continue to provide all available information on the ongoing reorganization of nursing studies and the adoption of new educational standards for nurses and medical assistants, the establishment of bilateral arrangements and partnerships with foreign nursing institutions as well as any other measures likely to impact on the quality of nursing services and the employment and working conditions of nursing personnel.

Article 7. Occupational safety and health of nursing personnel. The Committee notes the Government’s reference to various recently adopted legislative texts and ministerial orders in the field of occupational safety and health, including Presidential Decree No. 132/2006 on measures to achieve greater effectiveness in the fight against dangerous infectious diseases, and Presidential Decree No. 220/2008 on the Coordinating Council on the issues of HIV/AIDS, tuberculosis and drug addiction.

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 would be grateful if the Government would supply up to date information concerning the application of the Convention in practice, including, for instance, statistical data and characteristics of the composition of the nursing workforce (e.g. age, gender), statistics on the number of nurses entering and leaving the profession per year, the nurse-to-population ratio, copies of official reports or studies addressing nursing-related issues, any practical difficulties encountered in applying the Convention, etc.

Direct Request (CEACR) - adopted 2004, published 93rd ILC session (2005)

The Committee takes due note of the Government’s report and the attached documentation. The Committee notes in particular the numerous legislative texts adopted from May 2002 to June 2003 in respect of public health care and medical services. It also notes the Government’s indication that the Ministry of Health is in the process of elaborating a revised version of Act No. 2802-XII of 19 November 1992 on the fundamentals of Ukrainian legislation on public health care. The Committee once again requests the Government to transmit a copy of the Public Health Care Act currently in force and would be pleased to receive a copy of the revised text as soon as it is adopted.

Articles 2, paragraph 2(a), and 3, paragraph 1, of the Convention. The Committee notes the Government’s statement that the Ministry of Health has elaborated, in consultation with the Ministry of Labour and Social Policy, draft educational standards for nurses and medical assistants which should now be approved by the Ministry of Education and Science. Recalling that the Government in an earlier report had indicated that work on these standards would have been completed by the end of 1999, the Committee hopes that the basic requirements regarding nursing education and training will soon be established and asks the Government to forward a copy of the relevant text once it is formally adopted.

In addition, the Committee notes with interest the adoption of a ten-year Programme for the Development of Nursing Personnel (2002-11) which sets forth the major steps to be taken for the development of nursing personnel and the continuing improvement of its employment and working conditions. The Committee requests the Government to communicate information in its next report on all progress achieved in attaining the objectives and respecting the timeframe set out in the action plan.

As regards education and training, the Committee notes the Government’s reference to various institutional developments, such as for instance the introduction of multistage training and a new model of nurse training corresponding to international standards, the establishment of medical colleges and a network of higher education nurse-training institutions, the setting up of a state evaluation system for the assessment of nursing specialists conducting licensing examinations, and the preparation of training materials and manuals. The Committee is, however, unable to examine or comment upon these developments in the absence of any concrete details concerning their scope and impact. It therefore requests the Government to supply full particulars on the recent measures aimed at reforming nurse training and upgrading the quality of nursing services.

Articles 2, paragraph 4, and 5, paragraph 1. The Committee notes that the Government refers to the establishment of the National Nurses’ Association and other public associations of nurses. In this connection, the Committee would be grateful if the Government could provide in its next report more detailed information on the membership, powers and activities of the new bodies. In addition, the Committee asks the Government to elaborate in its next report on the practical manner in which the participation of nursing personnel in the planning of nursing services is ensured and consultations are conducted for the purpose of integrating the specific policy on nursing profession into the broader health-care policy framework.

Article 7. Further to its previous comment on this point, the Committee once again requests the Government to specify the social protection and security measures which have been drawn up for nursing personnel and other health-care specialists under the Act on the prevention of HIV/AIDS disease and the social protection of the population, and to forward a copy of all relevant texts.

Part V of the report form. The Committee notes the statistical information concerning the number of nurses currently employed in public health-care establishments. It notes in particular that nursing personnel now total 470,000 persons as compared to 502,572 in 1999 and 600,000 in 1993. The Committee would be grateful if the Government could continue supplying information on the application of the Convention in practice, including for instance statistics on the number of students attending nursing schools and the number of nurses leaving the profession, copies of official reports or research studies examining the employment and working conditions of nursing personnel, as well as any practical difficulties encountered in the implementation of the Convention.

Direct Request (CEACR) - adopted 1999, published 88th ILC session (2000)

The Committee notes the detailed information supplied by the Government in its report on issues such as education, theoretical and practical training, participation, and conditions of employment and work of nursing personnel.

The Committee also notes the information on the adoption of Law No. 2802.XII of 19 November 1992 "On introducing the foundations of Ukrainian legislation on public health care", and that other laws have been and continue to be drawn up regulating the activity of nursing personnel. The Committee would be pleased to receive a copy of the legislation related to the application of the Convention.

Articles 3, paragraph 1, of the Convention. The Committee takes note of the indication of the Government that in the implementation of a government decree, work is under way to establish educational standards for each speciality by the end of 1999. It requests the Government to supply a copy of these standards when they are adopted.

Article 5. The Committee notes the information of the Government according to which the Ministry of Health of Ukraine follows a policy of ensuring the participation of nursing personnel at all levels of planning and decision-making in the field of health care and that nurses also take part in the working groups, which draw up nursing curricula and teaching programmes. It also notes the indication that in a number of regions the post of chief specialist for nursing has been introduced in the regional and municipal health authorities.

Article 7. Further to its previous comments the Committee takes note of the information of the Committee in the report that in accordance with Ukrainian law "On the prevention of the illness of Acquired Immune Deficiency Syndrome (AIDS) and the social protection of the population", a list of social protection and security measures has been drawn up for nursing personnel and other health care specialists and workers designed to protect their health and promote safety at work. The Committee would be pleased to receive a copy of this law.

Part V of the report form. Please continue to provide general information on the way in which the Convention is applied in practice and also to supply, if possible, data on the number of the people leaving the profession.

Direct Request (CEACR) - adopted 1995, published 82nd ILC session (1995)

The Committee notes the detailed information supplied in the Government's report.

Article 7 of the Convention (in conjunction with Article 5). The Committee notes that the Ministry of Health is constantly trying to improve laws and regulations on occupational health and safety for all workers in the health sector, including nursing personnel. It would be grateful if the Government would state how the consultation and participation of the trade union organizations concerned are ensured in the preparation and implementation of the above measures. Furthermore, with reference to its general observation of 1990, which it repeated in 1994, the Committee asks the Government to indicate the measures taken or envisaged, in consultation with the employers' and workers' organizations concerned, to take account of the particular risk of accidental exposure to the human immune deficiency virus (HIV) among nursing personnel: for example, adjustment of working conditions, confidentiality of test results, recognition that the cause of the infection was occupational, etc.

Point V of the report form. Please continue to provide general information on the way in which the Convention is applied in practice and also to supply, if possible, data on the number of people leaving the profession.