Nursing Personnel Convention, 1977 (No. 149) - Belarus (Ratification: 1979)

Direct Request (CEACR) - adopted 2023, published 112nd ILC session (2024)

Articles 2(1), (2)(2)(a) and (3) of the Convention. National policy on nursing services and nursing personnel. In response to the Committee’s request, the Government of Belarus indicates that it has implemented various programs to enhance nursing services and personnel. These programs include the National Socio-economic Development Programme 2021–25, the National Public Health and Demographic Security Programme 2021–25, the National Social Protection Programme 2021–25, and the National Education and Youth Policy Programme 2021–25. They have also adopted an Action Plan for the development of nursing from 2021–25, with a focus on improving human resources policies, continuing professional education for nursing professionals, and the introduction of modern techniques in nursing. Furthermore, the Government is restructuring and reforming healthcare facilities to increase the role of professionals with intermediate healthcare and pharmacy education. They have introduced the position of male nurses and aligned their job descriptions with female primary-care nurses. The Government is also emphasizing the “team” principle in outpatient care facilities, with teams consisting of general practitioners, district nurses, general-practice nurses, and physician assistants specializing in outpatient care. The Government is also actively implementing measures outlined in the Joint Action Plan of the Ministry of Health and the National Committee of the Belarusian Trade Union of Healthcare Workers, focusing on awareness raising, monitoring wages and employment, and involving trade unions in organizational restructuring plans to promote employment. In terms of education and training for nurses, the Government follows the Education Code, the national classification of specialist areas and qualifications, and various educational standards. They have four medical universities providing higher healthcare and pharmacy education and 16 medical colleges offering intermediate-level education. These institutions participate in educational programs to improve information technology skills, professional mobility, and international competitions. The Government has also set up skills-training laboratories for nursing practice and procedures as part of the “Modernization of the Healthcare System of the Republic of Belarus” project.

The Committee requests the Government to provide detailed information on the impact of the above measures, particularly with regard to improvement of working conditions and professional competencies, and information on consultations held with employers’ and workers’ organizations. The Committee also requests the Government to provide copies of the Action plan and the Conceptual Framework, and any other official text adopted in the context of the implementation of a policy on nursing services and nursing personnel. The Committee further asks the Government to provide detailed information on the study programmes and of the number of persons enrolled in and graduating from nursing schools every year, disaggregated by sex and educational level, as well as statistical data on nurses, disaggregated by sex.

Article 5(1). Participation of nursing personnel in the planning of services. In response to the Committee’s previous request, the Government has provided information regarding the National Council for Nursing Service, which serves as a consultative and advisory body responsible for determining priority areas for nursing development, drafting regulations for nursing organization, and making proposals to enhance the supply of nursing professionals and educational resources. The Ministry of Health has issued Order No. 1098 in 2018, approving the composition and regulations of the National Council, which includes representatives from various institutions and associations, including the Chair of the National Committee of the Belarusian Trade Union of Healthcare Workers. The Government has also established regional councils on nursing, non-physician clinical practice, and midwifery in each region to improve nursing care, enhance the performance of mid-level healthcare workers, and upgrade the professional knowledge and practical skills of healthcare workers with intermediate vocational healthcare or pharmacy education. Decisions and recommendations from these regional councils are used to create regulations and guidance documents. Both the National Council and regional councils organize conferences, meetings, and seminars for professionals with intermediate vocational healthcare and pharmacy education. The Government has held national nursing conferences in 2018 and a national seminar in 2019 on primary care. Additionally, there have been a series of national educational seminars in 2020–21 and various face-to-face events in 2021 and 2022 related to healthcare workers. Furthermore, the Ministry of Health is working on a draft order to improve the organization of work for district nurses, general-practice nurses, and physician assistants in outpatient care. The Committee requests the Government to provide a copy of official documents revising the composition and rules of procedure of the National Council for Nursing Service, detailed information on the outcomes of the measures implemented by the National Council during the reporting period, and on the manner in which it is ensured that nursing personnel enjoy full-fledged participation in the National Council. The Committee also requests the Government to provide detailed information on the impact of measures taken by regional nursing councils to promote participation of nursing personnel in the planning of services and consultation on decisions concerning them. The Committee further requests the Government to provide a copy of the adopted order of the Ministry of Health on improving the organization of the work of district nurses, general-practice nurses and physician assistants in outpatient care.

Direct Request (CEACR) - adopted 2019, published 109th ILC session (2021)

Article 2(1) and (3) of the Convention. National policy on nursing services and nursing personnel. In response to the Committee’s 2014 direct request, the Government indicates that it gives effect to the provisions of the Convention through the Conceptual Framework for the Development of Nursing, which is being implemented through numerous programmes, including the National Socioeconomic Development Programme 2016–20, the National Public Health and Demographic Security Programme 2016–20, the National Social Protection and Employment Programme 2016–20, and the National Education and Youth Policy Programme 2016–20. The Government reports that a new draft conceptual framework for nursing has been developed with the active involvement of specialist staff from regional and municipal healthcare authorities and civil society organizations. The new framework focuses on, inter alia, increasing the prestige and significance of nursing personnel in the healthcare system, and increasing the professional skills of paramedical personnel. In addition, the Government indicates that general practice nurses and physician assistants constitute a new element in the strategy for the development of nursing, with primary care facilities introducing a team principle into healthcare at the district level, through teams consisting of a district physician or general practitioner, a district or general practice nurse and a physician assistant. The Government also indicates that, in 2018, it revised the job profile of primary care nurses. As a result, primary care nurses now enjoy certain rights, including the right to make suggestions regarding the working conditions required to ensure high-quality performance, the right to join professional and civil society bodies and the right to access professional education. The Committee notes with interest the adoption of the joint action plan developed by the Ministry of Health of the Republic of Belarus and the National Committee of the Belarusian Trade Union of Healthcare Workers to carry out a series of measures aimed at implementing the main provisions of the National Socioeconomic Development Programme 2016–20. The plan envisages joint action to, among others, improve public health, provide productive employment and enhance social support to people in vulnerable situations. First-level trade union organizations of healthcare workers conduct oversight of working conditions of healthcare workers, protecting their employment-related interests. Based on the findings of the trade union bodies, management of healthcare institutions take measures to improve the working conditions of paramedical personnel and standardize performance requirements. The Committee notes that, according to the World Bank document PAD1711 published in 2016 (Report No: PAD1711) no programmes for training of general practice nurses are being implemented in any of the medical colleges in Belarus. The Committee requests the Government to provide detailed information on the nature and impact of measures implemented as part of the conceptual framework for nursing as well as measures implemented under the joint action plan, particularly with respect to measures taken to improve the working conditions and professional competencies of nursing personnel. The Committee further requests the Government to continue to provide information on the manner in which it ensures the effective application of Article 2(2)(a) (education and training appropriate to the exercise of the functions of the nursing personnel).

Article 5(1). Participation of nursing personnel in the planning of services. In response to the Committee’s previous request, the Government refers to the activities of the National Council on Nursing, which include calling an annual meeting to review the work of paramedical personnel as well as organizing conferences and roundtables on relevant topics for this group of workers. The Government adds that a nursing council is present in every region, supported by a chief external expert in the organization of the work of paramedical professionals, who is an official from the Ministry of Health. The Committee notes that the Government does not provide information on the manner in which the participation of nursing personnel in the planning of services and consultation are promoted, as contemplated in Article 5(1). The Committee reiterates its request that the Government provide a copy of the instruments establishing the composition and rules of procedure of the National Council on Nursing Services, as well as detailed information on the activities and outcomes of the measures implemented by the National Council. It further requests the Government to provide information on the activities of regional nursing councils, their impact on the planning of healthcare services and the measures taken to promote the participation of the planning of nursing services and consultation on decisions that concern them.

Direct Request (CEACR) - adopted 2014, published 104th ILC session (2015)

Article 2(1) and (3) of the Convention. National policy on nursing services and nursing personnel. The Committee notes the Government’s report in reply to its previous comment. The Government mentions a number of programmes through which nursing services are being developed in the country for the period 2011–15. The Committee requests the Government to further elaborate on the aspects of these programmes related to nursing services and nursing personnel, particularly steps taken for their implementation and results. The Committee also requests the Government to indicate whether and how employers’ and workers’ representative organizations have been consulted in the formulation of these programmes, as required by Article 2(3) of the Convention.

Article 5(1). Participation of nursing personnel in the planning of services. The Committee asks the Government once again to transmit a copy of the instruments establishing the composition and rules of procedure of the National Council on Nursing Services as well as additional information on the activities of the National Council and the role and participation of the Nurses’ Association in its work.

Direct Request (CEACR) - adopted 2009, published 99th ILC session (2010)

Article 2, paragraph 1, of the Convention. National policy on nursing services and nursing personnel. Further to its previous comment, the Committee notes the Government’s indication that the draft Principles of Nursing 2009–14 have been drawn up together with measures to implement them. The draft Principles are designed among others to establish conditions favourable to nurses, increase efficiency and strengthen the role of nursing personnel in the delivery of primary health care, improve the training and skills development of nurses, develop new organizational forms of nursing and systems of management of nursing work, promote the establishment of nursing associations and their involvement in the reform of nursing work, and develop research in the field of nursing. The Committee also notes that the plan to implement these Principles includes measures aimed at improving the organization of work of nursing staff, developing professional training and staffing policy, and promoting international cooperation. It requests the Government to transmit a copy of the Principles of Nursing 2009–14 once they have been adopted, and further elaborate on the concrete steps taken for their implementation and the results obtained. It also requests the Government to clarify whether and how representative organizations of nursing personnel have been associated with the preparation of the draft Principles.

Articles 2, paragraph 2, and 6. Employment and working conditions of nursing personnel. The Committee notes the Government’s detailed indications about the preferential working conditions applicable to nursing personnel in light of the constraints and hazards inherent in the profession, particularly as regards wage increments, reduced working time and additional leave. It requests the Government to specify how the employment and working conditions of nursing personnel are determined in the private sector and to transmit copies of relevant collective agreements, if any.

Article 3. Nursing education and training. The Committee understands that there have been major changes in nursing education and training since 2002. There are currently 17 medical colleges and the duration of nursing studies has been extended to two years and ten months followed by a two-year compulsory work placement upon graduation. It requests the Government to provide an updated overview of the basic education and training curricula, specialization courses and registration requirements for nursing personnel.

Article 5, paragraph 1. Participation of nursing personnel in the planning of services. With reference to its previous comment, the Committee notes the adoption of Order No. 236 dated 27 March 2008 of the Ministry of Health establishing the National Council on Nursing Services composed of specialists from departments of the Ministry of Health, medical research and educational establishments, health establishments and professional associations. The Council’s main task is the development of the nursing profession, the coordination of nursing services and the elaboration of strategic orientations for improving the organization of work, the analysis and monitoring of the development of nursing, and the dissemination and evaluation of national and global experiences regarding nursing services. Its functions include the determination of priority orientations for the development of nursing, the participation in drafting relevant legislative instruments and the formulation of recommendations for improving staffing and nursing training. The Committee requests the Government to transmit a copy of the instruments establishing the composition and rules of procedure of the National Council on Nursing Services. It would also appreciate receiving additional information on the activities of the National Council so far and the role and participation of the Nurses’ Association in its work.

Article 7. Occupational safety and health of nursing personnel. The Committee notes the adoption of the new Occupational Safety and Health Act No. 356-Z of 23 June 2008. It also notes the adoption of Resolution No. 905 of the Council of Ministers of 16 August 2005 approving the national programme to improve conditions of work and occupational safety and health 2006–10. It further notes that sectoral documents on occupational safety and health have been prepared, including in the health sector, and specific model rules on protective equipment have been drawn up for health workers. More concretely, the Committee notes that, in the framework of the implementation of the Programme on Prevention of Infection 2006–10, approved by Resolution No. 1068 of the Council of Ministers of 12 August 2006, concrete measures have been taken especially with regard to education, training and retraining of medical staff, HIV/AIDS awareness, use of protective equipment, and introduction of safe technologies and instruments. The Committee requests the Government to continue providing full particulars on any measures, legislative, administrative or others, seeking to improve the occupational health and safety standards applicable to health-care workers.

Part V of the report form. Application in practice. The Committee notes that, according to the statistical information provided by the Government, in 2006, there were 118,327 intermediate medical personnel (including nurses), or 121 intermediate medical staff per 10,000 inhabitants. The Committee would be grateful if the Government would continue to supply all available information concerning the application of the Convention in practice, including, for instance, statistical data and characteristics of the composition of the nursing workforce (e.g. age, gender), the number of nurses exiting or joining the profession every year, the nurse-to-population ratio, copies of official reports or studies addressing nursing-related issues, any practical difficulties experienced in the application of the Convention, etc.

Direct Request (CEACR) - adopted 2004, published 93rd ILC session (2005)

The Committee notes that the Government, in its succinct report, indicates that there have been no changes in national legislation and practice with respect to the application of the Convention during the reporting period. The Committee observes, however, that the Government has failed to provide concrete information in response to its previous comments. It is therefore bound to reiterate its request for clarifications and documented information regarding the application of the following provisions of the Convention.

Article 2, paragraph 2(b), of the Convention. To enable the Committee to better evaluate the consistency of the national policy concerning nursing services and nursing personnel with the requirements of the Convention, the Government is requested to provide full particulars, including official texts and statistics, on the employment and working conditions of health-care workers including career prospects and remuneration. While noting the Government’s statement in an earlier report that current legislation provides for bonuses in the form of wage supplements and increased leave for district nurses and certain other categories of medical staff with middle-level medical training, the Committee asks the Government to transmit copies of all legislative texts providing for such benefits. It also renews its request for copies of the resolution of the Council of Ministers No. 724 of 1 December 1992 and of the Order of the Ministry of Health No. 232 of 19 August 1998 to which reference was also made in past reports.

Article 5, paragraph 1. The Committee requests the Government to specify how it is ensured in law and in practice the participation of nursing personnel in the planning of nursing services and consultation with such personnel on decisions concerning them, as required under this Article of the Convention. The Committee would appreciate receiving copies of any relevant laws or regulations in this respect. While recalling the Government’s past reference to the establishment of the National Nurses’ Council and the National Nurses’ Association and the convening of the first Nurses’ Congress in 1995, the Committee would also be grateful if the Government could supply additional information on the activities of these bodies and any recent decisions or initiatives taken for the improvement of the existing conditions under which the nursing profession is exercised and nursing care is provided. In addition, the Committee understands that hospital partnership programmes are currently under way with foreign institutions aiming at upgrading the skills of nursing staff and addressing the critical need for improved health care. In this regard, the Committee would welcome all practical information on the implementation and the outcome of such projects.

Article 7. The Committee requests the Government to continue providing information on any measures, whether legislative, administrative or others, aimed at improving the occupational safety and health conditions in which the nursing profession is carried out. It also requests the Government to provide up-to-date information on the preventive measures taken or contemplated with respect to the risk of accidental exposure to HIV/AIDS among nursing personnel as well as on any known cases of infection.

Part V of the report form. The Committee asks the Government to supply all available information on the application of the Convention in practice, including, for instance, statistical data on the number of nurses currently employed in both the public and private sectors, the distribution of nursing personnel by geographical region, the ratio of nurses to population, the number of students attending nursing schools and the number of nurses leaving the profession, copies of recent studies or publications examining the employment and working conditions of nursing personnel, as well as any practical difficulties encountered in the implementation of the Convention.

Direct Request (CEACR) - adopted 1999, published 88th ILC session (2000)

Article 2, paragraph 2(b), of the Convention. The Government takes note of the information provided by the Government in its report. It notes that Order No. 232 of 19 August 1998 of the Ministry of Health provides for the procedure of awarding qualification grades for medical and pharmaceutical staff but that no reference is mentioned in relation to the nursing personnel. The Committee requests the Government to supply a copy of Resolution No. 724 of 1 December 1992 of the Council of Ministers.

Article 4. In its previous report the Government has informed that the right to exercise the medical profession, including the nursing profession, is provided for under the Act of 18 June 1993 "On the Health Service". However, the Committee notes that Chapter XI of this Act, Rights, obligations and responsibility of medical and pharmaceutical personnel, applies exclusively for medical and pharmaceutical personnel. The Committee hopes that the Government will provide information on the laws or regulations which specify the requirements for the practice of nursing.

Article 5, paragraph 1. The Committee recalls that this provision of the Convention provides for promoting the participation of the nursing personnel in the public and private sectors in the planning of nursing services and the consultation with such personnel on decisions concerning them. The Committee is therefore bound to request again the Government to supply information on the legal provisions or regulations which have been adopted to ensure the application of the Convention on these points.

Article 7. The Committee takes note of the information provided by the Government according to which measures have been taken as regards working conditions, confidentiality and recognition for nursing personnel of infection by HIV as an occupational cause. It requests the Government to indicate if consultations with the employers' and workers' organizations have taken place for the adoption of the abovementioned measures. The Committee hopes that the Government will continue to provide information on the adoption of other measures to avoid or minimize the risks of exposure of healthcare workers to the AIDS virus.

Part V of the report form. Please continue to supply general information on the manner in which the Convention is applied in practice and also supply, where possible, information on the number of persons leaving the profession.

Direct Request (CEACR) - adopted 1995, published 82nd ILC session (1995)

The Committee notes the detailed report supplied by the Government and requests it to provide additional information on the following points.

Article 2, paragraph 2(b), of the Convention. Please indicate the various legal provisions and regulations applicable to nursing personnel in the public and the private sectors which are likely to attract persons to the profession and retain them in it, in accordance with this provision of the Convention.

Article 4. Please supply a copy of the Public Health Act adopted on 18 June 1993 by the Supreme Soviet of the Republic of Belarus.

Article 5. Please indicate the legal provisions or regulations which have been adopted to promote the participation of nursing personnel in the public and the private sectors in the planning of nursing services and the consultation with such personnel on decisions concerning them.

Article 7. The Committee notes the Government's constant concern, with the participation of trade union organizations, with the formulation and observance of occupational safety and health measures. Furthermore, with reference to its general observation of 1990, which was reiterated in 1994, the Committee requests the Government to indicate the measures which have been taken or are envisaged, in consultation with the employers' and workers' organizations concerned, to take into account the particular risk of accidental exposure to the human immunodeficiency virus (HIV) among nursing personnel: for example, through the arrangement of working conditions, the confidentiality of test results, recognition that the cause of infection was occupational, etc.

Point V of the report form. Please continue to supply general information on the manner in which the Convention is applied in practice and also supply, where possible, information on the number of persons leaving the profession.