SO much has been said and written about the challenges besetting the health sector including the strike by doctors in 2019 to press the government to award them salary increments and improve their working conditions. The doctors have since petitioned the High Court for an order to compel the government to address their grievances.

Another important, albeit long-suffering part of the healthcare service system are the nurses. The Sunday Express’ (SE) senior reporter, Limpho Sello, recently caught up with the Director Nursing Services in the Ministry of Health, Mpoeetsi Makau, (MM) to understand the state of the nursing sector in Lesotho. Below are excerpts of the interview.

SE: What are the highlights and positive achievements of the nursing sector last year and in recent years? 

MM: Making health services accessible even in hard to reach areas of the country has been one of our biggest achievements in recent years.

Nurses and midwives are the only health professionals found at all levels and settings of health delivery system and they have made a positive impact on the reduction of maternal and new born mortality rates. They have also made anti-retroviral drugs accessible, hence improving the quality of care for HIV positive patients. They have also contributed to reducing the rate at which babies are exposed to HIV and to promoting healthy lifestyles.

SE: We have seen doctors strike over pay and poor working conditions. Are the nurses happy with their working conditions? 

MM: The retention of nurses is not so good especially in those hard to reach areas due to lack of retention packages and other incentives from government. Nurses working in those areas are get similar packages to those working in better resourced urban areas and yet they face far greater challenges.

Nurses want retention packages to keep them in the remote areas and they have tabled these demands to their principals in the health ministry and their remuneration structure has to be reviewed.

 SE: Among other things, doctors have complained about the shortage of equipment in hospitals. How serious is this a challenge for nurses? 

MM: This is quite a challenge because a nurse cannot measure a patient’s blood pressure when there is no blood pressure machine. It makes it difficult to carry out this and other tests in order to come up with a nursing diagnosis and management.

SE: What are other challenges are nurses faced with? 

MM: In summary, there is lack of equipment, shortage of nursing staff including shortages of specialized nursing staff.

For example, we have lack of critical nursing specialist such as those who specialize in the pediatrics (care of children); specialists for the operating theatre, anesthetists, primary health care givers and midwives.

There is also a delay in the recruitment of nurses and the failure to retain nurses in the remote areas.

SE: What is the cause of these challenges? 

MM: The Ministry of Health depends on other ministries to implement its goals. For example, to train nurse in certain specialties or to fill or create a nursing position, our ministry has to go through other ministries.

As things stand, we have shortages of nurses at all levels. There is need to review the strategic plan of nursing and midwifery this year. We recommend that a new remuneration structure and retention package be approved.

There must be multi-spectral and inter-ministerial approaches to address health issues. Health is the responsibility of the individual, family, community, non-governmental organisations, the media and line ministries. These must engage where necessary.

We had our first meeting with our partners in January 2020 and another one with all nursing and midwifery pillars where we were the discussing the roles and responsibilities of each of us especially in this year which has been earmarked as the Year of the Nurse and the Midwife by the World Health Organisation (WHO). This has been done to appreciate the contribution of nurses and midwives towards attainment of Universal Health Coverage (UHC). Other meetings will follow with different stakeholders.

SE: How many nurses do you need and how many are already in the system? 

MM: The Ministry of Health is expanding services to include male and adolescent friendly health services, a cancer centre and we are regionalising the Motebang and Mafeteng hospitals among other things. We are also opening other health facilities closer to the communities and this means we need more nurses and midwives to work there.

There is a need of more than 2000 nursing and midwifery personnel and there are currently about 1250 nurses and midwives employed by government.

SE: How do you plan to capitalise on the International Year of Nurses to ensure that by the end of the year you should have achieved some of your goals? 

MM: The Media is our entry point and so we are going to engage more with the media so that the good work done by nursing and midwifery personnel is known locally, regionally and internationally.

We will involve communities more in issues affecting their health especially those that are led by nurses and midwives to reduce maternal and new-born mortalities among others.

We will also take advantage of international activities such as the Nightingales’ Challenge where nursing and midwifery leaders and employers are asked to train young nursing and midwifery personnel in leadership so that they sustain the profession.