Solicitud directa (CEACR) - Adopción: 2024, Publicación: 113ª reunión CIT (2025)

Convenio sobre el personal de enfermería, 1977 (núm. 149) - Congo (Ratificación : 1986)

Article 2 of the Convention.Formulation of a national policy concerning nursing services and nursing personnel. The Government reports that, in 2021, the Congo had 4,250 nurses for 5,836,000 inhabitants, namely 8.6 nurses for every 1,161 inhabitants. The Government indicates that, on the occasion of International Nurses Day in 2023, the National Coordinating Committee of Nurses’ Associations of the Congo spoke of a shortage of nursing staff and the need to set up a national corps of nurses. The Government also indicates that it has launched a campaign to recruit new public service employees, which has resulted in the recruitment of just over 4,000 health workers during the 2019-23 period, taking account of all occupations and qualifications, and it therefore expects a substantial increase in the number of nurses over the next five years. The Government also states that it has adopted a national health policy (PNS) for 2018-30, which is not specifically concerned with nursing staff; in order to make up for the shortage of healthcare staff, and in accordance with the PNS, a “Strategic human resources development plan for health” is currently being drawn up, covering training, recruitment, equitable distribution, motivation, retention and management of healthcare staff. In this regard, the Committee emphasizes that achieving and maintaining a qualified and motivated nursing workforce requires governments to invest in more and better education, including lifelong learning, to improve working conditions and to create decent jobs that provide opportunities for advancement (see General Survey of 2022, Securing decent work for nursing personnel and domestic workers, paragraph 176). The Government points out that the involvement of the social partners in the drawing up of the “Strategic human resources development plan for health” is not yet defined at this stage, and that workers’ trade unions such as the Trade Union Federation of Health and Social Workers (FESYTRASAS) and the National Federation of Health and Social Workers (FENASAS) could be involved. The Committee emphasizes in this respect that, to ensure that the national policy is comprehensive, it is important for other relevant actors, particularly nursing professionals and their professional institutions, to be consulted and participate actively in the development and implementation of the national policy in order to ensure that the views and concerns of all relevant actors are taken into account (see General Survey of 2022, paragraph 128). Since the “Strategic human resources development plan for health” is in the process of being drawn up, the Committee once again requests the Government to indicate what steps have been taken to ensure the consultation and participation of the representatives of nursing personnel in this regard. The Committee also once again requests the Government to provide detailed, up-to-date information on the measures taken to provide nursing personnel with, firstly, education and training appropriate to the performance of their duties and, secondly, conditions of employment and work likely to attract nursing personnel to the profession and retain them in it. The Committee further requests the Government to continue providing information on the ratio of nursing personnel to the number of inhabitants. Lastly, the Committee once again requests the Government to provide information on the distribution of nursing personnel between urban centres and rural areas.

Article 3. Education and training of nursing personnel. The Government indicates that training for nursing personnel is provided by the Faculty of Health Sciences and by five paramedical and medico-social schools located in Pointe-Noire, Dolisie, Kinkala, Brazzaville and Owando, adding that a private establishment, the Technical Institute of Nursing Sciences, also offers initial training. The Government reports that, according to a survey carried out a few years ago, the problems encountered in the training of nursing staff in public establishments are: obsolete facilities, intake capacity, classroom equipment, outdated curricula and teaching materials, the relationship between theory and practice, and teacher training (up to 80 per cent of teachers are temporary, depending on the establishment). The Committee notes with interest the Government’s indication that it has undertaken major reforms in this area, including as part of the “Project to support the development of human resources in health (PADRHS)” in partnership with the University of Montreal. The Government indicates that the PADRHS has made it possible to: (i) set up university paramedical training programmes that comply with bachelor’s degree, master’s degree and doctorate (LMD) standards; (ii) develop new teaching tools; and (iii) improve the learning environment by placing issues of ethics and professional conduct at the focus of training. The Committee notes that, according to the PNS, since 2012 the Government has also been involved in a programme to train health professionals abroad (in Cuba, China, Morocco, Russia, Türkiye and other countries). The Committee requests the Government to continue providing detailed, up-to-date information on the problems encountered in the training of nursing personnel, and on the measures and programmes taken or envisaged to address them. It also requests the Government to provide information on the impact of these measures, including statistical data on the number of graduates and the planning of nursing services.

Article 4. Requirements for the practice of nursing. Since the Government has sent an incomplete copy of Decree No. 88-430 of 6 June 1988 determining the requirements for the autonomous exercise of medicine and paramedical and pharmaceutical services, the Committee once again requests the Government to provide a copy of this Decree.

Article 5. Participation of nursing personnel in the planning of nursing services. The Government indicates that Congo has a tradition of collective bargaining and that labour disputes in hospitals are dealt with in accordance with the provisions of the Labour Code, namely, first within the hospital, then before the labour inspector and, if necessary, within the framework of a specialist institution such as the National Committee for Social Dialogue (CNDS). The Government adds that, in the event of a dispute at hospital level, the parties involved are the hospital’s trade union sections and the management, whereas in the event of a dispute at national level, the parties involved are the trade union federations or confederations and the Ministry of Health. Recalling that, under Article 5(3) of the Convention, the settlement of disputes arising in connection with the determination of terms and conditions of employment for nursing personnel must be sought through negotiations between the parties or in such a manner as to ensure the confidence of the parties involved, through independent and impartial machinery, the Committee requests the Government to provide information on any collective or sectoral agreement signed regarding the conditions of work of nursing personnel and to provide a detailed description of the machinery for the settlement of collective disputes which is in use for nursing personnel, in accordance with the provisions of the Labour Code. With regard to procedures other than negotiation, the Committee also requests the Government to indicate the manner in which they are established and whether the parties concerned have been consulted on this matter.

Article 6. Conditions of employment and of work of nursing personnel. The Committee notes that Order No. 9033 of 10 December 1986 on the structure and operation of socio-medical centres in enterprises established in Congo, sent by the Government with its report, does not contain any provision concerning the conditions of work of nursing personnel. The Committee therefore once again requests the Government to indicate the manner in which it ensures that nursing personnel employed in the private sector enjoy conditions of work at least equivalent to those of other workers, in accordance with Article 6 of the Convention.

Article 7. Adaptation of occupational health and safety measures to the special nature of nursing work. The Government indicates that since the end of 2010 a number of initiatives have been in place in enterprises and establishments in the private sector relating to the prevention of HIV infection, adding that protocols have been put in place in this regard specifically for healthcare personnel. However, the Government also indicates that since the Ministry of Health has eased the pressure on this matter, there is no doubt a growing need to conduct an evaluation of the situation. In view of the above, the Committee requests the Government to provide detailed, up-to-date information on all safety measures taken or envisaged for nursing personnel designed to limit as much as possible the risk of contracting HIV. The Committee also requests the Government to provide information on any evaluation conducted in this regard.