ZIMBABWE NURSES ASSOCIATION PRESENTATION REGIONAL NETWORK OF NATIONAL NURSES ORGANIZATIONS IN SOUTHERN AFRICA WITH LABOUR UNION STATUS 11 – 14 FEBRUARY 2010 SWAZILAND PREPARED BY REGINA P. SMITH ZIMBABWE NURSES ASSOCIATION PRESIDENT and SIMANGALISO MAFA ZINA GENERAL SECRETARY
Zimbabwe Nurses Association (ZINA) is a vibrant nurses organization for the Republic of Zimbabwe. It was founded in 1980 and currently has a membership of about 4800 out of a possible 16000 members. Membership is voluntary • It is a participatory non-governmental organization. The affairs of the Association are managed by a Standing Committee of 6 members plus 10 Provincial Branch Chairpersons to make up 16 National Executive Committee members, headed by the current association’s President Mrs Regina Smith. Our country has a National Nurses Act with a Nursing Council in place and Code of Ethics. Nurses Council governs the practice of nursing. ZINA constitution was enacted in 1980. • ZINA draws its membership from all health institutions in Zimbabwe, Public Sector and Private Sector, all qualified nurses who join receive a full membership status and all student nurses and nurse aides who join receive associate membership status. Retired nurses who remain actively participating in the association may receive honorary membership status.
Mission Statement • Zimbabwe Nurses Association (ZINA) aims to successfully negotiate for good working environment and good working conditions that ensure comfort and safety of the patient/client and the nurse in every health care institution in Zimbabwe . • Driven by team spirit (ZINA) ensures that it represents nurses in the country through visionary leadership that is sensitive to national health aims, influence health policy, advancing the profession through continuing education, practice and research, partnership enhancement and promoting the highest standard of nursing care.
Vision • Zimbabwe Nurses Association (ZINA)’s vision is to be the leading Association in Zimbabwe with a membership of not less than 80%. The strength of the Association (ZINA) is to lobby for better working conditions and remuneration to attract retain and recruit more nurses thereby improving nursing care provision to individuals, families and the Zimbabwe community.
ZINA Functions • Support and supervision of ZINA activities is done by the elected ZINA Trustee, who assist and guide the National Executive Committee in running affairs on behalf of the association and its membership. • The Association is a supportive body for all nursing matters geared to education, service, leadership development, standards and quality nursing care. It is important then that ZINA is involved in all nursing issues especially by empowering nursing to protect the right to health for the people of Zimbabwe. • ZINA is the only voice of nurses in Zimbabwe covering Public Sector, Private Sector, Local Authorities and Mission Institutions.
The Association is affiliated to Regional, International and Local unions/associations to include Southern African Network for Nurses and Midwives (SANNAM), East, Central and Southern Africa College of Nursing (ECSACON), International Council of Nurses (ICN), Public Service International (PSI) and locally it networks with organizations like Public Service Association, Zimbabwe Teachers Association among the list. This scenario is healthy in the running of the Association because exchange of notes and ideas is critical in the Association business. Affiliation Status
CURRENT STATUS OF THE ORGANIZATION • Zimbabwe Nurses Association (ZINA) as a mother body has subgroups under its umbrella. These groups include the Association of Midwives, Anaesthetists, Occupational Health Nurses, Mental Health Nurse who all are affiliated to ZINA. All these spearhead the nurses cause. • Currently the Association is in the process of rebuilding and restructuring after the inception of the new leadership under President Regina P. Smith. • Membership is very low due to apathy and poor working conditions which contribute to massive resignations into private sector, region and international market where pastures are said to be greener. • Subscriptions to the association is only USD1.00 per member per month which is insufficient to meet the recurrent costs to run the Association.
Continued • The subscriptions only started after almost 2 years without any meaningful subscriptions which were eroded by hyper-inflation. • The Association is unable to retain Office staff due to poor conditions of service. Coordinator and Bookkeeper resigned ermasse citing uncompetitive salaries. Fortunately the Association has managed to employ a Bookkeeper but it still struggles to employ a Coordinator due to financial constraints. • The Executive is not mobile due to shortage of transport for the Executive and the financial status of the organization. This affects the recruitment drive and educational tour to our valued members. • We have to cover 10 Provinces to meet and recruit more members.
ZINA’s Sources of Income • The source of income besides subscription is through selling ZINA regalia like jerseys, scarfs and badges. • Main sustainability plans:- • We plan to have poultry, rabbits projects in every provinces. • Tuck-shops. • To increase subscription once the salaries of our members are increased and stabilized. • We plan to erect a 3 storey building behind our offices to accommodate nurses from provinces who would have come for post Graduate courses.
Challenges to Nursing and Health Services Provision The HIV/AIDS pandemic has also taken its toll among nurses. Fortunately, the nurses are not medically boarded but they are counselled and started on ART. Support groups are also formed to help the nurses who are infected and affected. Financial support is very critical to the nurses HIV/AIDS groups but the association is failing to help meaningfully because of its current financial status. Massive resignation of Senior Nursing staff for greener pastures affected our membership and services. Human Resources, internal and external brain drain of health professionals is still experienced.
Civil Society/Donors and NGOs are still skeptical about the Zimbabwean situation so the country is facing a uphill task in promoting and creating enabling environment for investor confidence for donors and NGOs. • Health funding is too little leading to poor infrastructure, obsolete equipment which need replacement, shortages of linen, drugs, sundries and other tools of the trade. • Re-emergency of infections diseases previously under control like TB. • Food insecurity to the population which causes a threat to their health this year’s rains are erratic posing no hope for a good harvest.
The Association continues to lobby for better working conditions for its members who are currently earning an average of USD150,00 per month which is far below the Poverty Datum Line (PDL) of USD502,00. The pathetic salaries have led to massive resignations of mostly Midwives and nurses with specialities. • The country is facing financial crisis but the workforce needs reasonable remuneration and this puts the Association under immense pressure to deliver whilst they face hardships from the employer who fails to budge because of lack of financial muscle. • If a sister Association can bail us by coming up with an emergency fund which can be used to kick start projects which can benefit nurses it will be greatly appreciated.
Political Contact and Influence: Country Context • In every country, government at all levels has a critical role to play in responding to the health needs of the nation. At national level the role may be primarily one of the leadership, policy formulation and resource allocation. At local level the role is much more immediate and intimate. The formation of the Inclusive government in February 2009 ushered in new era of Governance. Things started to change for the better with improved availability of food in shops, drugs in health facilities and political stability. The pressure or influence of external focus which can impact negatively on the health of individuals, community and nation like sanctions is now the focus of the inclusive government to unlock gates of development.
Continued • Politicians are not interfering in the running of the Association. • Contact with Politicians is made through lobbying for their support to support the nurses cause for better working conditions and change of the Labour Law regime which is not favourable when it comes to aspects of Collective Bargaining and freedom of expression like strikes. • Politicians are supportive to see us fall under one Labour Law in Zimbabwe.
Continued • The introduction of multi currency has brought a lot of relief to the country but all the Civil Servants earn far much less the PDL of USD502 per month though at least they can afford to buy some basics. • Nurses fall under the Health Service Board where presentations for better working conditions are made. Meetings are held on regular basis reviewing progress.
Challenges in Sustaining the Association • Lack of finances to meet Organizational costs. • Executive not mobile to meet membership on recruitment drive and educational tours. • Low membership due to apathy. • Low salaries for nurses. • Unfavourable Labour Laws where the Association does consultations not proper collective bargaining.
Continued…. • Lack of funds to pay affiliation fees to organizations like International Council of Nurses (ICN). • Some Nurses gained negotiation skills through the Public Service International (PSI) sponsored shop steward workshops training in 2007 which was great. But, we still face challenges in that most nurses are not well versed in Labour Law regime of the country. As we are to harmonize to fall under one umbrella Labour Act Nurses need to be trained in Collective Bargaining and Labour Laws. Our major challenge is lack of finances to start the training.
Progress Report on Country/Indicators • There is a marked improvement in women participation in decision making. Zimbabwe boasts of a lady Vice President and a lady Vice Prime Minister. • There are also reasonable Ministries which are headed by ladies like the Ministry of Labour and Gender Ministry. • HIV/AIDS prevalence rate has dropped from a high rate of 30% to as low as 16%. • Family Planning knowledge is around 98% (Zimbabwe Demographic Health Survey 2007).
Continued….. • Literacy rate is above 85%. • Fertility rate fell from 5.4 births per women in 1998 to 3.8 births per women in 2007. • Sadly, Maternal Mortality rate rose from below 100 to above 718/100 000 births. • Life expectancy continues to fall and it is now below 40 years.
Continued…. • Unemployment rate is still above 85%. • Public Service salaries are between USD100,00 – USD200,00 per month. • Inflation rate is below 1%. • Poverty Datum Line is around USD502,00. • The Public now access ARVs in Public Institutions for free. • We are optimistic that salaries and nurses working conditions will improve soon.
Nursing Disciplines Statistics • General Nurse 22425 • State Certified Nurse 4766 • State Certified Traumatology Nurse 418 • State Certified Nurse for Mental Handicap 1 • Primary Care Nurse 3481 • Midwife 5979 • Midwives (Only) 6 • State Certified Maternity Nurse 3368 • State Certified Maternity Nurse (Only) 18 • Psychiatric Nurse 859 • Psychiatric Nurse (Only) 15
Bachelor of Science Degree 68 • Clinical Nurse 52 • Community Nurse 168 • Intensive Care Nurse 231 • Masters of Science 12 • Nurse Administrators 346 • Nurse Anaesthetist 121 • Nurse Educators 125 • Operating Theatre Nurse 397 • Opthalmic Nurse 61 • Paediatrics (Only) 1 • Paediatrics Nurse 24 I Thank You