Transcript Botswana presentation

NURSES ASSOCIATION OF
BOTSWANA
Geetha Feringa, MEd, RN
Executive Secretary
Esther Seloilwe, PhD, RN
President
Botswana
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COUNTRY CONTEXT
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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
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COUNTRY CONTEXT CONT’D
TYPE
(Source: CSO Botswana, UNDPHDI Report 2009 and
globalhealthfacts.org)
UN-HDI
BOTSWANA
ZAMBIA NAMIBIA
SPAIN
125
164
128
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GDP Per Capita in
US $ (2008)
13,300
1,500
5,400
34,600
Adult Literacy rate
83%
71%
88%
98%
Poverty (PDL)
30.6%
68%
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Unemployment rate
(%)
17.5%
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13.9
Population increase
1.3%
2.6%
1.9%
0.2%
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COUNTRY CONTEXT CONT’D
TYPE
(Source: CSO Botswana and UNDP- HDI
Report 2009)
BOTSWANA
ZAMBIA NAMIBIA
SPAIN
UN-HDI
125
164
128
15
Gov. expenditure (in % of national
budget) on health
17.8
10.8
10.1
15.3
Gov. expenditure per capita on
health (US $)
487
29
218
1,732
Fertility rate
2.9
5.9
3.4
1.4
Maternal Mortality Rate (100 000)
326
449
210 - 449
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12.59
101.20
45.51
4.21
Nurses / midwives per 10 000
27
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76
Doctors per 10 000
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1
3
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Hospital beds per 10 000
24
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Infant Mortality Rate (1000)
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COUNTRY CONTEXT CONT’D
CONDITION
REMARKS
HIV/AIDS
•Prevalence rate 17.6%
•Prevalence age 30-44: + 40.2%
•Incidence rate: 2.89%
TB
Amongst pregnant women:
•Prevalence + 27%
•Incidence: 470/100 000
• MDR-TB
(BAIS III of 2008)
(TB Coordinator, 2007)
Cancer
8255 (2002), expected to have doubled. Breast, cervical, skin,
prostate (cancer register).
Other most common
Respiratory infections
Gastro-enteritis / diarrhea
Chronic diseases (HTN, Diabetes, Obesity)
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RECENT INFLUENCING FACTORS
• Elections (2009)
• Economic recession (contraction of the
economy)
• Public sector reforms
• Human Resource Development Strategy
• Transformation Tertiary Education System
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HEALTH SERVICE PROVISION
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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
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NURSES’ CONTEXT
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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)
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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.
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NURSING CHALLENGES
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Lack of strategic nursing plan at national level.
Lack of DNS.
Limited CE opportunities.
Exclusion scarce skills remuneration.
Work related risk: e.g. HCW TB (7-24 fold)
 Job satisfaction.
 HIV/AIDS.
 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.
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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.
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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.
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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.
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INTERNATIONAL AFFILIATIONS
ORGANIZATION
YEAR JOINED
International Council of
Nurses (ICN)
15 May 1973
Commonwealth Nurses
Federation (CNF)
1979
ECSACON
1990
SANNAM
Confederation of Midwives
(ICM):
2002
Pending
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OVERVIEW NAB (see handout)
SOCIO
ECONOMIC
WELFARE
(SEW)
PROFESSIONAL
DEVELOPMENT
PROFESSIONAL
REGULATION
NAB
MEMBERSHIP
RELATIONS
BUSINESS
ORGANIZATIONAL
GOVERNANCE
AND
MANAGEMENT
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SUSTAINABILITY
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Membership
- Pula 25-00 / month
- Funeral fund subscription
- Airtime (incl. free mobile phone) subscription
- Free IT services
- Corporate items
- Fundraising
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Cafeteria
- Restaurant
- Catering Services
- Hosting Workshops
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Rentals
- Hostel rooms
- Preschool premises
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Project funding
- ICN
- SANNAM
- PEPFAR (CFC)
- American Embassy
- Private
- Ministry of Health (Botswana Nurses Day / release nurses, etc.)
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CURRENT MAIN CHALLENGES
• Unionization.
• Exclusion scarce skills.
• Buildings:
- Renovations
- Inadequate office space
• Membership:
- numbers
- involvement
•  Staff
• Sustainability
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THANK YOU
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