NURSES ASSOCIATION OF BOTSWANA Esther Seloilwe, PhD, RN President Onalenna Lemo, MSc.-CHN, MPA(HR), B Ed, RM, RN Project Coordinator Geetha Feringa, M Ed, RN, Executive Secretary
COUNTRY CONTEXT • Independence in 1966. • Democratic Republic of Botswana • Landlocked, ,mostly flat, hot, arid. • Capital: Gaborone • Population: - 1.8 million. - urbanized (> 51%) - concentrated in South East - relatively young (34.2% = <15) - growth rate declining (currently estimated at 1.3%) • Access to Health Services: - 84% within 5 km radius - 95% within 8 km radius
HEALTH SERVICE PROVISION • GOVERNMENT • PHC based • Referral system, from mobile health post to referral hospital • Nurses are first contact between population – health services • Initial costs: Pula 5-00 (elderly, destitutes and <5’s exempted) • PRIVATE • Mines, missions, private, NGO’s • Fees based • Approx. 20% of pop. covered by medical insurance
HIV & AIDS situation in Botswana • HIV prevalence in Botswana is 17.6% among the general population (BIAS III, 2008). • Prevalence rate for 15-19 & 20-24 year olds 6.6% & 19.0% respectively. • Female (20.4%) prevalence is higher than males (14.2%) • Prevalence & incidence higher in urban areas than in rural areas (BAIS III, 2008
HIV & AIDS situation in Botswana • Prevalence rate (22.1%) in towns, (19.1%) in cities & 16.6% in rural areas • Incidence rate in cities is higher (3.4%) compared to 2.3% in rural population • Incidence rate high among 45 to 49 years (2.95%) and low in 15-19 years (0.7%). • HIV incidence rates also follow a similar trend by gender - higher in females (3.5%) than males (2.3%).
MDG 6 mapping TARGET Will target be reached? To halt and reverse the incidence of HIV, particularly the youth by 2016. Likely. Environment conducive. To reduce the no. of infants born to HIV infected mothers who are HIV positive by their 18th month by half by 2006 and to zero by 2009. Potentially. Good environment. To reduce the morbidity and mortality caused by TB. Likely. Environment conducive. To reduce the incidence of confirmed malaria to below 20 cases per 1000 people. Potentially. Strong conducive environment. Eldisa LLoshi , UN Coordination Analyst, UNRC Office
RECENT INFLUENCING FACTORS • Economic recession: (contraction of the economy) influenced public and donor funding • Public sector reforms:The Integrated Result Based Management(IRBM) system is based on the systematic and strategic identification of, and performance planning for, results at all levels, from the national, sectoral, ministerial and departmental, down to other lower levels. This system requires that all Key Result Areas (KRAs) and NDP 10 goals and programmes be results-oriented.(NDP 04/09)
ROLE OF NNA IN IMPROVEMENT OF UNIVERSAL ACCESS • Approx. 7.500 practicing nurses • Government largest employer (>88%) • Ratio: + 3.8 / 1000 • Global context <1 to > 12 / 1000 • WHO recommendation: 2.6 / 1000 • Vacancies: government + 250 or <4% (2009)
NURSES ASSOCIATION OF BOTSWANA • Founded 1968. • Professional organization • Membership: - Paid up: < 3,800 (50% of nurses in Botswana). - Trend: growing rapidly (4.5% -1998 to < 50% in 2010) • 24 Branches country wide.
VISION A well-prepared, highly motivated, united and organized nursing workforce, committed to the development of the profession, improvement of customer satisfaction and upholding the code of ethics and standards of professional practice.
MISSION In its pursuit for delivery of quality nursing services to its customers, NAB is committed to advance and maintain professional growth and integrity of its members.
SUSTAINABILITY • Membership - Pula 25-00 / month - Funeral fund subscription - Airtime (incl. free mobile phone) subscription - Free IT services - Corporate items - Fundraising • Cafeteria - Restaurant - Catering Services - Hosting Workshops • Rentals - Hostel rooms - Preschool premises • Project funding - ICN - SANNAM - PEPFAR (CFC) - American Embassy - Private - Ministry of Health (Botswana Nurses Day / release nurses, campaign etc.)
NURSING REGULATION • Regulated by: - Nurses and Midwifes Act - Nursing and Midwifery Council of Botswana (NMCB) • Nursing Standards in place (developed by NAB, enforced by the NMCB). • NAB President is board member of the NMCB.
CURRENT FOCUS • Unionization – constitution ready for registration • Recent AGM • Caring for the Care Giver programme • International Year of the Nurse (IYN): The proud to be a nurse image campaign.
Unionization • Activities ongoing. • Constitution ready for registration. • Lack of funds for training and implementation. • Competition with other unions. • Problems in establishing National Bargaining Council.
Caring for the Care givers SYNOPSIS This program was started in 2002 after acknowledging the impact of HIV/AIDS on the nursing profession, nurses being the major health care providers in Botswana, this despite the stress already being caused by being affected and infected themselves In this era of HIV and AIDS, NAB has become an important organ in helping nurses to overcome the burden of nursing AIDS patients and helping HIV positive people, people dying of AIDS and their families in overcoming grief.
AIM The overall aim of the CfC programme is to promote the health and wellbeing of nurses through personal and professional support to empower them in their role as health care providers.
OBJECTIVES • To provide palliative care services, psychosocial support and spiritual care and support to nurses and health workers in Botswana, through health workers support groups. • To provide individual care and support to individual nurses affected by HIV/AIDS and other diseases and health related conditions.
OBJ. Continued • To strengthen the professional development of nurses and health workers in Botswana. • To develop wellness centres for Health Care workers to address their health and related needs in a private and protected environment. • To carry out research activities related to the impact of HIV/AIDS and other factors impacting on their performance. • To advocate and lobby for policies sensitive to the needs of nurses and health workers.
MAJOR ACHIEVEMENTS • INDICATORS AS PER BOTUSA (ORIGINAL)
BOTTLENECKS • Failure to release participants as per quota by health facilities • Release of participants who do not have a passion • Shift make it difficult to meet regularly • Issues of confidentiality • Issues of core business
INTERNATIONAL YEAR OF THE NURSE (IYN): The proud to be a nurse image campaign. AIM To improve the image, reputation and motivation of nurses and midwives providing health services in Botswana. OBJECTIVES • Develop and disseminate information about how to create a positive image of nursing. • Motivate nurses to take pride in service provision. • Encourage respect for the nursing profession from the public and the nurses themselves.
INTERNATIONAL YEAR OF THE NURSE (IYN): THE PROUD TO BE A NURSE IMAGE CAMPAIGN. ACHIEVEMENTS • Funding elicited (Self, MOH, USA student nurses). • Material developed. • Corporate items secured. • 40 Ambassadors trained. • Media exposure (radio / TV / newspapers) • Currently on the campaign trail country wide. • Survey administered to public and nurses. • Evaluation meeting 8-9 December. • Follow up 2011.
MAJOR CHALLANGE LACK OF POSITION OF DIRECTOR OF NURSING SERVICE
ASSOCIATED ILLS • Lack of strategic nursing plan at national level. • Exclusion scarce skills remuneration. • Work related risk: e.g. HCW TB (7-24 fold) • Job satisfaction. • Working conditions. • Salaries. • Quality of life. • Transfers. • Professional development. • Moonlighting. • Recognition of post basic qualifications. • Migration (7.4%) both internal and external (2007). • Workplace Violence. • Staff development / leadership development. • Review nursing standards. • Image of nurse • HIV/AIDS
NURSING MATTERS THANK YOU PULA !!!!