Direct Request (CEACR) - adopted 2020, published 109th ILC session (2021)

Nursing Personnel Convention, 1977 (No. 149) - Guinea (Ratification: 1982)

Article 2 of the Convention. National policy concerning nursing services and nursing personnel. In reply to its previous comments, the Committee notes the Government’s indication that, following the Ebola haemorrhagic fever virus outbreak that severely affected Guinea between 2014 and 2016, measures were adopted to establish a National Health Security Agency and implement the National Health Care Development Plan (PNDS) for the 2015–24 period. In this regard, the Government refers to, among other measures, the formulation of the Community Health Policy, which is essentially based on health promotion and disease prevention, the adaptation of training for technical health workers so that they can serve as community technical health workers, the training of community health intermediaries and the classification of regions into four health zones based on distance from the capital city. The Government also indicates that measures have been adopted to ensure that nursing personnel are provided with education and training appropriate to the exercise of their functions, including the implementation of the license–master–doctorate system in the training of nursing personnel and the development and incorporation into the nursing curriculum of training modules on infection prevention and control, community health and integrated disease surveillance. The Government adds that measures are also planned to incorporate paramedical and nursing tracks and course options in the new Faculty of Health Techniques and Sciences. Furthermore, the Government refers to the implementation of measures to improve employment and working conditions, including career prospects and remuneration that are likely to attract people to the nursing profession and retain them in it. Among these measures, the Government refers to the payment of regional bonuses to health-care personnel assigned to Zones 3 and 4, which are considered to be difficult, and a rural pilot project intended to retain personnel in their assigned post. Lastly, the Committee notes that, in its concluding observations of 20 March 2020, the United Nations Committee on Economic, Social and Cultural Rights (CESCR), while noting the numerous programmes adopted to improve the level of health of inhabitants, including the formulation of a national health policy, also expressed concern at the high maternal and infant mortality rates, the high prevalence of HIV/AIDS and the lack of access to antiretroviral treatment, the lack of medical facilities and the dilapidated condition of existing facilities, the lack of training for medical personnel, the low number of medical personnel per capita and the excessive burden health-care expenditure represents for low-income households (E/C.12/GIN/CO/1, paragraph 43). The Committee requests the Government to provide detailed information on the implementation and impact of the National Health Care Development Plan (PNDS) for the 2015–24 period and the Community Health Policy with regard to nursing personnel. It also requests the Government to continue providing detailed and updated information on the measures adopted to ensure the availability of the nursing care necessary for the population (Article 2(1)) and on the measures adopted to provide nursing personnel with education and training appropriate to the exercise of their functions (Article 2(2)(a)). It also requests the Government to continue providing detailed and updated information on the employment and working conditions, including career prospects and remuneration, that are likely to attract personnel to the profession and retain them in it (Article 2(2)(b)).

Article 6. Conditions of employment and work of nursing personnel. In reply to its previous comments, the Committee notes the Government’s indication that the conditions of employment and work of nursing personnel are regulated by Act No. 028/AN of 3 July 2018 on the general organization of the public administration (revised) and the particular statute applicable to health personnel. In addition, the Government indicates that measures have been adopted to ensure that nursing personnel benefit from conditions that are at least equivalent to those of other workers in the public service. These measures include the recognition of specialized diplomas for nursing personnel, the accordance of value to higher-education or specialized diplomas in the public service, measures benefiting nursing personnel with higher-education diplomas and the creation of high-level posts within the administration. However, the Committee notes that the Government does not provide information regarding the conditions of work of nursing personnel in the areas specified in Article 6 of the Convention. Consequently, the Committee once again requests the Government to provide detailed and updated information on the conditions of work of nursing personnel in the following areas: (a) hours of work, including regulation and compensation of overtime, inconvenient hours and shift work; (b) weekly rest; (c) paid annual holidays; (d) educational leave; (e) maternity leave; (f) sick leave; and (g) social security. It also requests the Government to continue providing information on the measures adopted or envisaged to ensure that nursing personnel benefit from conditions at least equivalent to those of other workers in the country in such fields. In addition, the Committee once again requests the Government to provide a copy of any texts regulating the conditions of employment and work of nursing personnel.

Article 7. Occupational safety and health. In reply to the Committee’s previous comments, the Government refers to the implementation of measures to guarantee as far as possible the safety of nursing personnel during epidemiological crises. In this regard, the Government indicates that individual and collective protection measures have been adopted, health committees and biomedical waste incinerators have been set up in health-care facilities, health personnel have been trained in prevention and protection against infection, and hygiene products and materials have been provided to health-care facilities. The Government indicates that, as a result of these measures and compliance with physical distancing measures, the country is gradually emerging from the COVID-19 pandemic. It indicates that between the end of March and 16 August 2020, the country recorded 8,343 infected persons, 6,210 of whom recovered (87.4 per cent). The Government adds that these statistics indicate the progress made by the country’s health-care services in combating this disease. In the context of the COVID-19 pandemic, the Committee draws the Government’s attention to Paragraph 49 of the Nursing Personnel Recommendation, 1977 (No. 157): “(1) All possible steps should be taken to ensure that nursing personnel are not exposed to special risks. Where exposure to special risks is unavoidable, measures should be taken to minimize it. (2) Measures such as the provision and use of protective clothing, immunization, shorter hours, more frequent rest breaks, temporary removal from the risk or longer annual holidays should be provided for in respect to nursing personnel regularly assigned to duties involving special risks so as to reduce their exposure to these risks. (3) In addition, nursing personnel who are exposed to special risks should receive financial compensation.” The Committee also draws the Government’s attention to the ILO Guidelines on Decent Work in Public Emergency Services (2018), which recognize the need to protect public emergency services workers against exposure to communicable diseases, particularly emergency medical personnel. In particular, paragraphs 50 and 51 of the Guidelines emphasize that suitable and sufficient personal protective equipment (PPE) should be provided to emergency public services workers as protection against exposure to hazardous conditions, and the workers and/or their representatives should be consulted and participate in the selection of PPE and the determination of its correct use. Noting that nursing personnel, due to their frequent close contact with patients, are at high risk of infection when treating confirmed or suspected COVID-19 patients if infection-control precautions, including the use of personal protective equipment (PPE), are not strictly applied, the Committee requests the Government to provide detailed and updated information on the safety measures adopted or envisaged, including the provision of PPE and training in its use, the granting of adequate breaks during shift changes and limiting working hours as far as possible, to protect the health and welfare of nursing personnel and to limit as far as possible the risk of contracting COVID-19.

Part V of the report form. Application in practice. The Committee notes that, according to the Global Health Observatory of the World Health Organization (WHO), the total number of nursing personnel in 2016 was 1,010 nurses and 443 midwives. The Committee requests the Government to provide detailed and updated information on the application in practice of the Convention, including statistics disaggregated by sex, age and region on the ratio of nursing personnel to the general population, the number of people enrolled in nursing schools and the number of nurses who enter and leave the profession each year. It also requests the Government to provide information on the organization and operation of all institutions that provide health services, and to provide studies, surveys and official reports on the difficulties encountered by health personnel in the health sector in Guinea.