Nurses in Nigeria’s public hospitals began a seven-day “warning” strike on Wednesday, demanding improved remuneration, better working conditions and increased recruitment, after a two-week ultimatum to the government expired without resolution.

The National Association of Nigeria Nurses and Midwives (NANNM) warned that if their demands are not met by next week, the union will embark on an indefinite strike, the first in over two decades.

“We hope that before the seventh day, we’ll have attention and positive response from the federal government,” said Christianah Adeboboye, head of the nurses’ and midwives’ union in Lagos.

A meeting on Tuesday between the union and a government delegation led by Labour Minister Muhammad Dingyadi ended in a stalemate.

“When you look at the composition of the meeting, it already shows that no outcome could have been gotten out of that meeting,” said Toba Odumosu, union secretary in Lagos, citing the absence of Health Minister Ali Pate as a critical gap.

The impasse underscores the growing rift between healthcare workers and the government, leaving patients vulnerable as hospitals brace for further disruptions.

The union is pushing for the recruitment of more nurses, pointing to a sharp decline in personnel as over 42,000 nurses have left Nigeria for jobs abroad in the past three years, according to the Nursing and Midwifery Council of Nigeria.

Reuters

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There has been mixed reaction to Health Minister Aaron Motsoaledi’s announcement that the government will advertise 1200 jobs for doctors, 200 for nurses and 250 for other healthcare professionals at the cost of R1.78 billion.

While the African National Congress and the Congress SA Trade Unions welcomed the announcement, the Democratic Nursing Organisation of SA, which is affiliated to Cosatu, expressed deep disappointment about the number of nurses to be recruited.

Denosa spokesperson Sonia Mabunda-Kaziboni said on Friday it was shockingly inadequate and downright insulting to the nursing fraternity.

“The health department has not only failed to respond meaningfully to the dire shortage of nurses across the country, but it has also shown a disturbing lack of shame in publicly announcing the recruitment of a mere 200 nurses, as though it were a breakthrough,” she said.

“This token gesture, coming after repeated calls for urgent and large-scale investment into nursing human resources, is a slap in the face to the thousands of nurses who are already stretched beyond capacity.”

National projections estimate that the country could be short by over 100,000 nurses by 2030 if urgent interventions are not made. In the Free State alone, there is a 28% vacancy rate.

Mabunda-Kaziboni said these shortages had devastating impacts such as compromising patient care, with fewer nurses caring for more patients.

A longer waiting period in hospitals and nurses emigrating due to untenable working conditions further compounding the problem.

Denosa acknowledged the minister’s reference to the procurement of hospital beds, mattresses and linen items. However, it was concerned that if these procurements were managed through the current tendering system, they would fall victim to corrupt practices.

“The tender system has become a breeding ground for looting and inefficiency, and unless transparency and accountability are prioritised, the funds allocated will be squandered, and frontline facilities will see little benefit,” said Mabunda-Kaziboni.

Cosatu spokeswoman Zanele Sabela sad described the recruitment drive as a progressive move by Motsoaledi and the Health Ministry, saying it spoke directly to the cries of professionals in this crucial public service sector.

She said Cosatu also applauded Motsoaledi for taking steps towards readying the public health system for the eventual implementation of the National Health Insurance, including the finalisation of an audit of hospital beds required.

ANC spokeswoman Mahlengi Bhengu-Motsiri said the intervention demonstrated the government’s commitment to strengthening the public healthcare system and ensuring that quality care was accessible to all South Africans.

“It reflects a serious and proactive response to the challenges facing the sector. The ANC has long recognised the urgent need to increase the number of healthcare professionals, particularly in under-resourced communities.

“While this measure may not fully meet the growing demand, it is a significant step forward. We are confident it will help ease pressure on healthcare facilities and enhance patient care,” she said in a statement.

Denosa has called on the Health Department to urgently implement a comprehensive nurses’ recruitment and retention plan, targeting thousands of new nursing appointments.

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President Cyril Ramaphosa has appealed to the Democratic Nursing Organisation of SA (Denosa) to get to the bottom of why the country’s nurses are being recruited out of the country, which is depleting the number of nurses.

Addressing the DENOSA’s 9th congress in Boksburg in Ekurhuleni on Tuesday, Ramaphosa said he was encouraged that this matter would be discussed by the union.

“You need to discuss how we deal with the spectrum of recruitment that is taking place amongst those of your profession to other countries. Is it money?” asked the president to which the congress responded with a roaring yes.

The president said there was a time when others argued that nurses should be allowed to leave the country and earn foreign currency, but they were leaving in droves.

Ramaphosa also said he was encouraged that delegates would deliberate on accreditation for nurses.

While it was encouraging to see more new nursing registrations with the South African Nursing Council, there was a decline in training numbers.

“This decline cannot be simply explained by less people seeing nursing as an attractive career, but that factors such as accreditation delays also play a part in all this. And I don’t know why the accreditation process is taking so long with so many of you wanting to be part of your profession.

‘Now I welcome the fact that this is one of the issues under discussion at this congress. I am hoping that you are going to come out with an answer or a solution,” he said.

The president said the union should ensure that the training and capacity-building efforts underway in support of its members aligned with community needs as well as with the evolution of diseases.

He encouraged delegates to be more engaged in policy development efforts and ensure that as new policies emerged, the nursing profession made inputs. It also must consider the impact on new policies on its members.

“The support of Denosa will be pivotal as we prepare for National Health Insurance. The passage of the NHI Act was a milestone in our ongoing quest for a more just society, where one’s ability to access quality healthcare and services is not determined by where one comes from or one’s ability to pay,” he said.

Ramaphosa said nurses would be the backbone of the NHI. The right to dignity mattered the most when people were sick because that was when they needed help and were at their most vulnerable.

He urged Denosa to be at the forefront of discussions around upskilling and training, strengthening health systems and other crucial matters.  

“Beyond preparation for NHI, the nursing profession faces emerging challenges. Many of these [are] on the congress agenda, such as litigation against nurses and the growing trend of undocumented patients from neighbouring countries seeking treatment in South African public health facilities,” the president said.

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