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ZIMBABWE NURSES ZIMBABWE NURSES ASSOCIATION PRESENTATIONASSOCIATION PRESENTATION

REGIONAL NETWORK OF NATIONAL NURSES REGIONAL NETWORK OF NATIONAL NURSES ORGANIZATIONS IN SOUTHERN AFRICA WITH ORGANIZATIONS IN SOUTHERN AFRICA WITH

LABOUR UNION STATUSLABOUR UNION STATUS

11 – 14 FEBRUARY 201011 – 14 FEBRUARY 2010

SWAZILANDSWAZILAND

PREPARED BY REGINA P. SMITHPREPARED BY REGINA P. SMITH

ZIMBABWE NURSES ASSOCIATION PRESIDENTZIMBABWE NURSES ASSOCIATION PRESIDENT

andand

SIMANGALISO MAFA SIMANGALISO MAFA

ZINA GENERAL SECRETARYZINA GENERAL SECRETARY

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Zimbabwe Nurses Association (ZINA) is a vibrant nurses Zimbabwe Nurses Association (ZINA) is a vibrant nurses organization for the Republic of Zimbabwe. It was founded organization for the Republic of Zimbabwe. It was founded in 1980 and currently has a membership of about 4800 out of in 1980 and currently has a membership of about 4800 out of a possible 16000 members. Membership is voluntarya possible 16000 members. Membership is voluntary It is a participatory non-governmental organization. The affairs of the It is a participatory non-governmental organization. The affairs of the

Association are managed by a Standing Committee of 6 members plus 10 Association are managed by a Standing Committee of 6 members plus 10 Provincial Branch Chairpersons to make up 16 National Executive Provincial Branch Chairpersons to make up 16 National Executive Committee members, headed by the current association’s President Mrs Committee members, headed by the current association’s President Mrs Regina Smith. Our country has a National Nurses Act with a Nursing Regina Smith. Our country has a National Nurses Act with a Nursing Council in place and Code of Ethics. Nurses Council governs the practice Council in place and Code of Ethics. Nurses Council governs the practice of nursing. ZINA constitution was enacted in 1980.of nursing. ZINA constitution was enacted in 1980.

ZINA draws its membership from all health institutions in Zimbabwe, ZINA draws its membership from all health institutions in Zimbabwe, Public Sector and Private Sector, all qualified nurses who join receive a Public Sector and Private Sector, all qualified nurses who join receive a full membership status and all student nurses and nurse aides who join full membership status and all student nurses and nurse aides who join receive associate membership status. Retired nurses who remain actively receive associate membership status. Retired nurses who remain actively participating in the association may receive honorary membership status.participating in the association may receive honorary membership status.

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Mission StatementMission Statement

Zimbabwe Nurses Association (ZINA) aims to successfully Zimbabwe Nurses Association (ZINA) aims to successfully negotiate for good working environment and good working negotiate for good working environment and good working conditions that ensure comfort and safety of the patient/client conditions that ensure comfort and safety of the patient/client and the nurse in every health care institution in Zimbabwe .and the nurse in every health care institution in Zimbabwe .

Driven by team spirit (ZINA) ensures that it represents nurses Driven by team spirit (ZINA) ensures that it represents nurses in the country through visionary leadership that is sensitive to in the country through visionary leadership that is sensitive to national health aims, influence health policy, advancing the national health aims, influence health policy, advancing the profession through continuing education, practice and profession through continuing education, practice and research, partnership enhancement and promoting the highest research, partnership enhancement and promoting the highest standard of nursing care.standard of nursing care.

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VisionVision

Zimbabwe Nurses Association (ZINA)’s vision is to Zimbabwe Nurses Association (ZINA)’s vision is to be the leading Association in Zimbabwe with a be the leading Association in Zimbabwe with a membership of not less than 80%. The strength of membership of not less than 80%. The strength of the Association (ZINA) is to lobby for better working the Association (ZINA) is to lobby for better working conditions and remuneration to attract retain and conditions and remuneration to attract retain and recruit more nurses thereby improving nursing care recruit more nurses thereby improving nursing care provision to individuals, families and the Zimbabwe provision to individuals, families and the Zimbabwe community.community.

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ZINA FunctionsZINA Functions

Support and supervision of ZINA activities is done by the Support and supervision of ZINA activities is done by the elected ZINA Trustee, who assist and guide the National elected ZINA Trustee, who assist and guide the National Executive Committee in running affairs on behalf of the Executive Committee in running affairs on behalf of the association and its membership.association and its membership.

The Association is a supportive body for all nursing matters The Association is a supportive body for all nursing matters geared to education, service, leadership development, geared to education, service, leadership development, standards and quality nursing care. It is important then that standards and quality nursing care. It is important then that ZINA is involved in all nursing issues especially by ZINA is involved in all nursing issues especially by empowering nursing to protect the right to health for the empowering nursing to protect the right to health for the people of Zimbabwe.people of Zimbabwe.

ZINA is the only voice of nurses in Zimbabwe covering Public ZINA is the only voice of nurses in Zimbabwe covering Public Sector, Private Sector, Local Authorities and Mission Sector, Private Sector, Local Authorities and Mission Institutions.Institutions.

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Affiliation StatusAffiliation Status

The Association is affiliated to Regional, International and The Association is affiliated to Regional, International and Local unions/associations to include Southern African Local unions/associations to include Southern African Network for Nurses and Midwives (SANNAM), East, Network for Nurses and Midwives (SANNAM), East, Central and Southern Africa College of Nursing Central and Southern Africa College of Nursing (ECSACON), International Council of Nurses (ICN), Public (ECSACON), International Council of Nurses (ICN), Public Service International (PSI) and locally it networks with Service International (PSI) and locally it networks with organizations like Public Service Association, Zimbabwe organizations like Public Service Association, Zimbabwe Teachers Association among the list. This scenario is Teachers Association among the list. This scenario is healthy in the running of the Association because exchange healthy in the running of the Association because exchange of notes and ideas is critical in the Association business.of notes and ideas is critical in the Association business.

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CURRENT STATUS OF THE ORGANIZATIONCURRENT STATUS OF THE ORGANIZATION

Zimbabwe Nurses Association (ZINA) as a mother body has Zimbabwe Nurses Association (ZINA) as a mother body has subgroups under its umbrella. These groups include the subgroups under its umbrella. These groups include the Association of Midwives, Anaesthetists, Occupational Health Association of Midwives, Anaesthetists, Occupational Health Nurses, Mental Health Nurse who all are affiliated to ZINA. Nurses, Mental Health Nurse who all are affiliated to ZINA. All these spearhead the nurses cause.All these spearhead the nurses cause.

Currently the Association is in the process of rebuilding and Currently the Association is in the process of rebuilding and restructuring after the inception of the new leadership under restructuring after the inception of the new leadership under President Regina P. Smith.President Regina P. Smith.

Membership is very low due to apathy and poor working Membership is very low due to apathy and poor working conditions which contribute to massive resignations into private conditions which contribute to massive resignations into private sector, region and international market where pastures are said sector, region and international market where pastures are said to be greener.to be greener.

Subscriptions to the association is only USD1.00 per member Subscriptions to the association is only USD1.00 per member per month which is insufficient to meet the recurrent costs to per month which is insufficient to meet the recurrent costs to run the Association. run the Association.

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ContinuedContinued The subscriptions only started after almost 2 years without any The subscriptions only started after almost 2 years without any

meaningful subscriptions which were eroded by hyper-inflation.meaningful subscriptions which were eroded by hyper-inflation. The Association is unable to retain Office staff due to poor The Association is unable to retain Office staff due to poor

conditions of service. Coordinator and Bookkeeper resigned conditions of service. Coordinator and Bookkeeper resigned ermasse citing uncompetitive salaries. Fortunately the ermasse citing uncompetitive salaries. Fortunately the Association has managed to employ a Bookkeeper but it still Association has managed to employ a Bookkeeper but it still struggles to employ a Coordinator due to financial constraints.struggles to employ a Coordinator due to financial constraints.

The Executive is not mobile due to shortage of transport for the The Executive is not mobile due to shortage of transport for the Executive and the financial status of the organization. This Executive and the financial status of the organization. This affects the recruitment drive and educational tour to our valued affects the recruitment drive and educational tour to our valued members.members.

We have to cover 10 Provinces to meet and recruit more We have to cover 10 Provinces to meet and recruit more members.members.

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ZINA’s Sources of IncomeZINA’s Sources of Income The source of income besides subscription is The source of income besides subscription is

through selling ZINA regalia like jerseys, scarfs through selling ZINA regalia like jerseys, scarfs and badges.and badges.

Main sustainability plans:-Main sustainability plans:-

i.i. We plan to have poultry, rabbits projects in every We plan to have poultry, rabbits projects in every provinces.provinces.

ii.ii. Tuck-shops.Tuck-shops.

iii.iii. To increase subscription once the salaries of our To increase subscription once the salaries of our members are increased and stabilized.members are increased and stabilized.

iv.iv. We plan to erect a 3 storey building behind our We plan to erect a 3 storey building behind our offices to accommodate nurses from provinces who offices to accommodate nurses from provinces who would have come for post Graduate courses.would have come for post Graduate courses.

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Challenges to Nursing and Health Services ProvisionChallenges to Nursing and Health Services Provision The HIV/AIDS pandemic has also taken its toll among The HIV/AIDS pandemic has also taken its toll among

nurses. Fortunately, the nurses are not medically nurses. Fortunately, the nurses are not medically boarded but they are counselled and started on ART. boarded but they are counselled and started on ART. Support groups are also formed to help the nurses who Support groups are also formed to help the nurses who are infected and affected. Financial support is very are infected and affected. Financial support is very critical to the nurses HIV/AIDS groups but the critical to the nurses HIV/AIDS groups but the association is failing to help meaningfully because of association is failing to help meaningfully because of its current financial status.its current financial status.

Massive resignation of Senior Nursing staff for greener Massive resignation of Senior Nursing staff for greener pastures affected our membership and services.pastures affected our membership and services.

Human Resources, internal and external brain drain of Human Resources, internal and external brain drain of health professionals is still experienced.health professionals is still experienced.

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Civil Society/Donors and NGOs are still skeptical Civil Society/Donors and NGOs are still skeptical about the Zimbabwean situation so the country is about the Zimbabwean situation so the country is facing a uphill task in promoting and creating facing a uphill task in promoting and creating enabling environment for investor confidence for enabling environment for investor confidence for donors and NGOs.donors and NGOs.

Health funding is too little leading to poor Health funding is too little leading to poor infrastructure, obsolete equipment which need infrastructure, obsolete equipment which need replacement, shortages of linen, drugs, sundries and replacement, shortages of linen, drugs, sundries and other tools of the trade.other tools of the trade.

Re-emergency of infections diseases previously under Re-emergency of infections diseases previously under control like TB.control like TB.

Food insecurity to the population which causes a Food insecurity to the population which causes a threat to their health this year’s rains are erratic threat to their health this year’s rains are erratic posing no hope for a good harvest.posing no hope for a good harvest.

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The Association continues to lobby for better working The Association continues to lobby for better working conditions for its members who are currently earning an conditions for its members who are currently earning an average of USD150,00 per month which is far below the average of USD150,00 per month which is far below the Poverty Datum Line (PDL) of USD502,00. The pathetic Poverty Datum Line (PDL) of USD502,00. The pathetic salaries have led to massive resignations of mostly salaries have led to massive resignations of mostly Midwives and nurses with specialities.Midwives and nurses with specialities.

The country is facing financial crisis but the workforce The country is facing financial crisis but the workforce needs reasonable remuneration and this puts the Association needs reasonable remuneration and this puts the Association under immense pressure to deliver whilst they face hardships under immense pressure to deliver whilst they face hardships from the employer who fails to budge because of lack of from the employer who fails to budge because of lack of financial muscle.financial muscle.

If a sister Association can bail us by coming up with an If a sister Association can bail us by coming up with an emergency fund which can be used to kick start projects emergency fund which can be used to kick start projects which can benefit nurses it will be greatly appreciated.which can benefit nurses it will be greatly appreciated.

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Political Contact and Influence: Country Political Contact and Influence: Country ContextContext

In every country, government at all levels has a critical role to In every country, government at all levels has a critical role to play in responding to the health needs of the nation. At play in responding to the health needs of the nation. At national level the role may be primarily one of the leadership, national level the role may be primarily one of the leadership, policy formulation and resource allocation. At local level the policy formulation and resource allocation. At local level the role is much more immediate and intimate. The formation of role is much more immediate and intimate. The formation of the Inclusive government in February 2009 ushered in new era the Inclusive government in February 2009 ushered in new era of Governance. Things started to change for the better with of Governance. Things started to change for the better with improved availability of food in shops, drugs in health improved availability of food in shops, drugs in health facilities and political stability. The pressure or influence of facilities and political stability. The pressure or influence of external focus which can impact negatively on the health of external focus which can impact negatively on the health of individuals, community and nation like sanctions is now the individuals, community and nation like sanctions is now the focus of the inclusive government to unlock gates of focus of the inclusive government to unlock gates of development.development.

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ContinuedContinued

Politicians are not interfering in the running of the Politicians are not interfering in the running of the Association.Association.

Contact with Politicians is made through lobbying for their Contact with Politicians is made through lobbying for their support to support the nurses cause for better working support to support the nurses cause for better working conditions and change of the Labour Law regime which is not conditions and change of the Labour Law regime which is not favourable when it comes to aspects of Collective Bargaining favourable when it comes to aspects of Collective Bargaining and freedom of expression like strikes.and freedom of expression like strikes.

Politicians are supportive to see us fall under one Labour Law Politicians are supportive to see us fall under one Labour Law in Zimbabwe.in Zimbabwe.

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ContinuedContinued The introduction of multi currency has brought a lot of relief The introduction of multi currency has brought a lot of relief

to the country but all the Civil Servants earn far much less to the country but all the Civil Servants earn far much less the PDL of USD502 per month though at least they can the PDL of USD502 per month though at least they can afford to buy some basics.afford to buy some basics.

Nurses fall under the Health Service Board where Nurses fall under the Health Service Board where presentations for better working conditions are made. presentations for better working conditions are made. Meetings are held on regular basis reviewing progress.Meetings are held on regular basis reviewing progress.

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Challenges in Sustaining the AssociationChallenges in Sustaining the Association

Lack of finances to meet Organizational costs.Lack of finances to meet Organizational costs. Executive not mobile to meet membership on Executive not mobile to meet membership on

recruitment drive and educational tours.recruitment drive and educational tours. Low membership due to apathy.Low membership due to apathy. Low salaries for nurses.Low salaries for nurses. Unfavourable Labour Laws where the Association Unfavourable Labour Laws where the Association

does consultations not proper collective bargainingdoes consultations not proper collective bargaining ..

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Continued….Continued….

Lack of funds to pay affiliation fees to organizations like Lack of funds to pay affiliation fees to organizations like International Council of Nurses (ICN).International Council of Nurses (ICN).

Some Nurses gained negotiation skills through the Public Some Nurses gained negotiation skills through the Public Service International (PSI) sponsored shop steward workshops Service International (PSI) sponsored shop steward workshops training in 2007 which was great. But, we still face challenges training in 2007 which was great. But, we still face challenges in that most nurses are not well versed in Labour Law regime in that most nurses are not well versed in Labour Law regime of the country. As we are to harmonize to fall under one of the country. As we are to harmonize to fall under one umbrella Labour Act Nurses need to be trained in Collective umbrella Labour Act Nurses need to be trained in Collective Bargaining and Labour Laws. Our major challenge is lack of Bargaining and Labour Laws. Our major challenge is lack of finances to start the training.finances to start the training.

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Progress Report on Country/IndicatorsProgress Report on Country/Indicators

There is a marked improvement in women participation in There is a marked improvement in women participation in decision making. Zimbabwe boasts of a lady Vice President decision making. Zimbabwe boasts of a lady Vice President and a lady Vice Prime Minister.and a lady Vice Prime Minister.

There are also reasonable Ministries which are headed by There are also reasonable Ministries which are headed by ladies like the Ministry of Labour and Gender Ministry.ladies like the Ministry of Labour and Gender Ministry.

HIV/AIDS prevalence rate has dropped from a high rate of HIV/AIDS prevalence rate has dropped from a high rate of 30% to as low as 16%.30% to as low as 16%.

Family Planning knowledge is around 98% (Zimbabwe Family Planning knowledge is around 98% (Zimbabwe Demographic Health Survey 2007).Demographic Health Survey 2007).

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Continued…..Continued…..

Literacy rate is above 85%.Literacy rate is above 85%. Fertility rate fell from 5.4 births per women in 1998 to 3.8 Fertility rate fell from 5.4 births per women in 1998 to 3.8

births per women in 2007.births per women in 2007. Sadly, Maternal Mortality rate rose from below 100 to above Sadly, Maternal Mortality rate rose from below 100 to above

718/100 000 births.718/100 000 births. Life expectancy continues to fall and it is now below 40 years.Life expectancy continues to fall and it is now below 40 years.

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Continued….Continued….

Unemployment rate is still above 85%.Unemployment rate is still above 85%. Public Service salaries are between USD100,00 – USD200,00 Public Service salaries are between USD100,00 – USD200,00

per month.per month. Inflation rate is below 1%.Inflation rate is below 1%. Poverty Datum Line is around USD502,00.Poverty Datum Line is around USD502,00. The Public now access ARVs in Public Institutions for free.The Public now access ARVs in Public Institutions for free. We are optimistic that salaries and nurses working conditions We are optimistic that salaries and nurses working conditions

will improve soon.will improve soon.

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Nursing Disciplines Statistics Nursing Disciplines Statistics

General NurseGeneral Nurse 2242522425 State Certified NurseState Certified Nurse 47664766 State Certified Traumatology NurseState Certified Traumatology Nurse 418418 State Certified Nurse for Mental HandicapState Certified Nurse for Mental Handicap 1 1 Primary Care NursePrimary Care Nurse 34813481 MidwifeMidwife 59795979 Midwives (Only)Midwives (Only) 66 State Certified Maternity NurseState Certified Maternity Nurse 33683368 State Certified Maternity Nurse (Only)State Certified Maternity Nurse (Only) 1818 Psychiatric NursePsychiatric Nurse 859859 Psychiatric Nurse (Only)Psychiatric Nurse (Only) 1515

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Bachelor of Science DegreeBachelor of Science Degree 6868 Clinical NurseClinical Nurse 5252 Community NurseCommunity Nurse 168168 Intensive Care NurseIntensive Care Nurse 231231 Masters of ScienceMasters of Science 1212 Nurse AdministratorsNurse Administrators 346346 Nurse AnaesthetistNurse Anaesthetist 121121 Nurse EducatorsNurse Educators 125125 Operating Theatre NurseOperating Theatre Nurse 397397 Opthalmic NurseOpthalmic Nurse 6161 Paediatrics (Only)Paediatrics (Only) 11 Paediatrics NursePaediatrics Nurse 2424

I Thank YouI Thank You