Direct Request (CEACR) - adopted 2022, published 111st ILC session (2023)

Nursing Personnel Convention, 1977 (No. 149) - Guyana (Ratification: 1983)

Article 2(1) of the Convention. Adoption of a policy concerning nursing services and nursing personnel. The Committee notes that, according to the 2018 WHO Country Cooperation Strategy report on Guyana, in December 2013, the “Health Vision 2020: A National Health Strategy for Guyana 2013-20” was adopted. The Committee notes that the Strategy was developed through a consultative process with a broad range of actors, including the Pan American Health Organization (PAHO) and the World Health Organization (WHO), health workers, the private sector, and civil society. A mid-term review was conducted in 2015, on the basis of which an implementation plan was developed and costed. The Strategy indicates that it supports the implementation of “Strengthening the Foundation: A Health Human Resource Action Plan for Guyana 2011-2016”, which aims to strengthen the capacity of the Ministry of Health to plan, manage, develop, and deploy human resources in heath towards the recruitment and retention of a diverse, qualified, health and highly motivated health workforce responsive to the population’s needs. In this respect, the Strategy envisages the adoption of, among other measures, exploring options to: improve health funding and incentive programmes and adjust the cadre and distribution of medical and nursing professionals to address gaps in identified service areas, particularly in rural health facilities and those in the interior of the country. With regard to the deployment and distribution of the health workforce, the Strategy envisages expanding adequate supportive structures and benefits for staff in hinterland locations (including staff quarters, hardship allowances, access to transportation and communications); exploring innovative options for community-based models of health care delivery and developing and implementing viable solutions in collaboration with communities; and exploring opportunities for public-private partnerships to cost-effectively contract select medical specialist services, including for delivery in interior locations. The Committee requests the Government to provide detailed, up-to-date information on the nature and impact of measures taken in the context ofNational Health Strategy for Guyana 2013-2020, as well as in the context of “Strengthening the Foundation: A Health Human Resource Action Plan for Guyana 2011-2016”. In particular, the Committee requests the Government to provide detailed information on the implementation and impact of those measures designed to provide nursing personnel with employment and working conditions, including education and training appropriate to the exercise of their functions, career prospects and remuneration, which are likely to attract persons to the profession and retain them in it, including in rural areas and remote communities. Noting that the National Health Strategy and Health Human Resource Action Plan have both expired, the Committee requests the Government to indicate whether these have been renewed or replaced and, if so, to provide copies.

Article 2(2)(a) and (3). Nursing education and training. The Committee notes that the National Health Strategy for Guyana 2013-20 envisages the adoption of measures aimed at strengthening the preparation of health professionals in terms of education, clinical skills, professional culture, and ongoing professional development; better aligning with changing requirements of clinical practice environment; strengthening the capacity of health education training programmes, at the didactic and clinical levels; providing quality learning environments that meet the needs of health professionals; expanding postgraduate nursing education ; and developing and expanding community service components of training. The Committee requests the Government to provide updated detailed information on the nature, implementation, monitoring and impact of the measures adopted, including those in the framework of the National Health Strategy for Guyana 2013-20, to ensure that nursing personnel, including midwives, are provided with quality education and training appropriate to the exercise of their functions, as well as to their professional career development, and the opportunity for continuing professional development, as contemplated in the Strategy.

Articles 4 and 5. Legislation concerning the requirements for the provision of nursing care and nursing services.Consultations with nursing personnel. The Committee notes with interest the adoption of the Nurses and Midwives Act, 2019, which includes provisions regarding the registration and regulation of nurses, midwives, nursing assistants and specialist nurses. The Act requires persons to be registered and hold a valid licence to be able to practice nursing or midwifery (section 14 of the Act). It also establishes the Nurses and Midwives Council, whose functions include: enrolling, registering, certifying, and licensing nursing personnel; establishing standards of education, training, conduct and performance for nursing personnel and ensuring the maintenance of those standards; promoting the interest of nursing personnel; and advising the Minister on matters related to nursing personnel (sections 3 and 4 of the Act). The Committee notes that the Council is composed of, among other actors, representatives of the Guyana Nurses Association and the Midwives Association of Guyana (section 6). The Committee requests the Government to provide detailed information on the measures taken or envisaged to ensure the participation of nursing personnel in the planning of nursing services and consultation with nursing personnel on decisions concerning them.

Article 7. Occupational safety and health. The Committee requests the Government to provide information on progress made and results achieved with respect to occupational safety and health for nursing personnel, including with respect to providing personal protective equipment (PPE) and training in its use, as well as providing adequate rest breaks during workers’ shifts and limitations on excessive hours wherever possible during and after the COVID-19 pandemic. It also requests the Government to provide information on the measures implemented to prevent and reduce psychosocial risks, and promote mental health and well-being among nursing personnel, in addition to preventing the risk of long-term effects on nurses’ well-being.

Application in practice. The Committee notes that, according to WHO statistical information, the number of nursing and midwifery personnel per 10,000 increased from 6.28 in 2014 to 35.3 in 2020. As of 2018, 96.62 per cent of nursing personnel were women and 3.38 per cent were men. The Committeerequests the Government to provide updated detailed information on the application of the Convention in practice, including statistical data disaggregated by sex, age and region concerning: the ratio of nursing personnel to the population; the number of persons enrolled in nursing schools; the number of female and male nurses who enter and leave the profession each year; the organization and the operation of all institutions which provide healthcare services; as well as official studies, surveys and reports addressing health workforce issues in the health sector.