Nurses migration: Onus on govt - Report

THATO CHWAANE
Staff Writer | Friday June 6, 2008 00:00

 

The study, by Gloria Thupayagale-Tshweneyagae of the Department of Nursing Education at the University of Botswana (UB) on request by Nurses Association of Botswana (NAB) in conjunction with Botswana Trade and Poverty Programme (BTTP), was released last year.

It suggests that there should be an exit interview so people know why employees leave to go and work in other countries. The study recommends that that would make employers improve conditions of service.

It also recommends that nurses be deployed according to their specialty. Government should also enter into trade agreements with other governments to train more nurses and supply them to other countries such as Australia, United Kingdom (UK), and United States of America (US).

It recommends that government  create a central international job site, so that those who want to migrate can be allowed to do so. It suggests that a certain percentage of their first salary could be paid to government. Government could generate some revenue through migration if viewed positively, the recommendation reads.

Nurses interviewed reported that they worked under very difficult conditions that are compounded by high nurse-patient ratios and high student-lecture ratios. They also reported that it takes a nurse 10 years to be promoted to the next level and an average of five years to be considered for further studies. They reported of inconsistencies and unfairness that occur with advancement and promotions. Although nurses have to line up for promotions and further studies they reported that on some occasions a nurse may skip this line and be promoted or sent for further studies, which is unfair and unjust.

The nurses are frustrated by the fact that they are not always deployed according to their specialty, which demotivates them and reduces their productivity, culminating in their migration. 

Pay is perceived to be low despite the fact that nursing is an essential service. Other issues raised are lack of fringe benefits, such as free accommodation and transportation to and from work, especially at night.

Survey data showed that salaries of nurses in Botswana do not match their qualifications and indicated that nurses have no other income except from their formal employment, the study states.

Transfers of nurses were seen to be a form of punishment. The study also revealed that some nurses migrated because they wanted to be exposed to other countries. Another factor is the HIV/AIDS pandemic that has resulted in overcrowding of patients. This overcrowding has frustrated nurses because it has interfered with the way they have been rendering care.

The pull factors of nurses migrating are better salaries. One nurse stated that she earns an equivalent of P22, 000 per month in Australia, more than half of what she was earning as a principal nursing officer in Botswana. Others reported their salaries having tripled.

They also stated there are opportunities for further training, better insurance and that they are allowed to work in different agencies or extend the hours in their regular jobs and be paid for it. A nurse with a specialty in nursing is recognised and earns the same salary as her UK counterpart.

The study stated that nurses who migrate from Botswana would want to return after achieving some of their needs such as buying a house and further education. They also noted better education for their children and a healthy bank account were other reasons for migration.

The other contributing factor for nurses migrating is that international agencies are still coming to Botswana for recruitment.

Botswana nurses are said to be migrating to countries such as Britain, US, Australia, New Zealand and Saudi Arabia. The current nursing shortage in Botswana is due to nurses leaving government institutions.

Between 1999 and 2005 about 232 nurses resigned from the public service and about 18 deserted. In 2006 about 146 nurses resigned while 24 nurses retired. Of the 24 who retired, 20 of them were below 60 years old, the study said.

The sample size of the study was 368 selected from hospitals, clinics, health posts, from schools of nursing, retired nurses and nurses with migration experience.