Transcript NURSES ASSOCIATION OF BOTSWANA

GREETINGS
FROM
BOTSWANA
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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
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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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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ATTAINMENT OF MDG’s (04/9 NDP)
Improvement of maternal
mortality rates
The Government aims to reduce
maternal deaths to 150 per
100,000 live births by 2011.
Reduction of infant and child
mortality
1971 child mortality stood at 97
per 1000
1994: IM 39 /1000; U5M 48/1000
HIV/AIDS reversed progress made
previously. 2006: IMR 51 & U5MR
76 (stat-MISCS 2000)
The aim is to reduce IM to
16/1000 & U5M to 27/1000 by
2015
Combat HIV/AIDS, malaria and other
diseases.
HIV prevalence has fallen from a peak
of over 30 percent in 1995, to 17.6
percent
in 2008.
ATTAINMENT OF MDG’S (NDP 04/09)
Promotion of gender equality and
the empowerment of women
The ratio of girls to boys in
primary and secondary education
remained above 100 percent
Universal primary education
The net enrolment rate for the
primary school age group, those
between 7 and 13 years, was 98.5
percent.
Eradicate extreme poverty and
hunger Poverty
Datum Line fell from 49 percent in
1993/94 to 30 percent in 2002/03,
and declined further to 23 percent
by the end of NDP 04/09.
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
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CONDITION
REMARKS
TB
Amongst pregnant women:
•Prevalence + 27%
•Incidence: 470/100 000
• MDR-TB
(TB Coordinator, 2007)
8255 (2002), expected to have
doubled. Breast, cervical, skin,
prostate (cancer register).
Cancer
Other most
common
Respiratory infections
Gastro-enteritis / diarrhea
Chronic diseases (HTN, Diabetes,
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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)
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ROLE OF NNA IN IMPROVEMENT OF
UNIVERSAL ACCESS
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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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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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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, campaign etc.)
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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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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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OVERVIEW NAB
SOCIO
ECONOMIC
WELFARE
(SEW)
PROFESSIONAL
DEVELOPMENT
PROFESSIONAL
REGULATION
NAB
MEMBERSHIP
RELATIONS
BUSINESS
ORGANIZATIONAL
GOVERNANCE
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MANAGEMENT
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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.
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Unionization
• Activities ongoing.
• Constitution ready for registration.
• Lack of funds for training and
implementation.
• Competition with other unions.
• Problems in establishing National
Bargaining Council.
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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.
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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.
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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.
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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.
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MAJOR ACHIEVEMENTS
• INDICATORS AS PER BOTUSA (ORIGINAL)
PEPFAR INDICATORS
NAB ACHIEVABLES
Number of individuals
served with palliative
care services
380 facilitators have
been trained;49
support groups are
functioning.
125 facilities reached
Number of facilities
reached with palliative
care messages
Number of individuals
trained in palliative
2083 health workers
reached
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SUPPORT GROUP TRAINING IN SESSION
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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
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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.
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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.
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MAJOR CHALLANGE
LACK OF POSITION OF DIRECTOR OF
NURSING SERVICE
ASSOCIATED ILLS
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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
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THANK YOU
PULA !!!!
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