The Role of the Nursing Leaders in Epidemic Control: Lessons learned from HIV service scale up in South Africa Dr JN Makhanya PhD Chief Nursing Officer, National Ministry of Health Republic of South Africa

Nursing in South Africa: Introduction SA national health system Public, Private and NGO sectors Stewardship role (National Ministry) Nurse-based services across the 3 sectors Regulated health sciences education & training Statutory health councils: SANC Nursing Policy management through Chief Nursing Office (recent) Review of the national role of the CNO in HIV policy formation, legislation and regulation of nursing practice

Role of Nursing in HIV Epidemic Control Education and Training Policy formulation & implementation Administration Practice Thematic involvement Leadership Scientific activities Community initiatives

Nursing Education & Training Role of the two Ministries – Education and health. Health sector a major employer for nurses South Africa has a quadruple burden of disease compared to other countries Has adopted Re- engineered of PHC as an approach to service delivery South Africa's nurse-based healthcare system requires nurses to have the competence and expertise to manage the country's burden of disease and meet South Africa's healthcare needs. Important to note that even though there are many changes in the nursing education & training landscape, many institutions are still applying the bedside teaching methods Exposure to different settings remains a critical aspect of nurse training especially at public nursing colleges Advances in SA nursing are also influenced by the strong research element arising out of nursing departments at higher education institutions Integration of HIV & AIDS education into nurse training has to be balanced with other serious public health concerns like the rise in lifestyle driven conditions like obesity, diabetes etc

Nursing Education Institutions Selection Criteria Northern Campus of FSSON   Mpumalanga College of Nursing Prince Mshiyeni Campus of KZNCN Support to implement New Professional Nurse Qualification Support to implement New Staff Nurse Qualification Support to implement New Specialist Nurse Qualification Focal areas Institutional programme submission to HEQC Academic staff development Pre-service curriculum development & implementation Clinical education strengthened through the preceptor programme Outcomes: Improved institutional and academic capacity Improved quality of nursing education Appropriately educated & trained competent nurses/ midwives are produced Impact Improved health outcomes for populations in low resourced settings and across the life span

Policy Formulation & Implementation CNO recently established and located at national Ministry of Health Role: Policy formulation, Harmonisation of nursing services Influence on pre-service education Liaison with international bodies on nursing Statutory regulation of nursing Education & training Scopes of practice Practitioner conduct Coordination role of CNO critical for advancement of nursing policy CNO has major implications for all aspects of nursing – practice, education & training, leadership, policy & regulation, resourcing and social relevance

Service / Practice Established role in public health programmes Removal of constraints in prescribing (HRH shortages) Specific role in HIV & AIDS epidemic Counselling and testing Awareness campaigns Initiation of treatment HIV & TB NIMART Necessitated by scale of epidemic Limited to professional nurse & midwife Forced a change in the scopes of practice Role of nursing and its leadership not a major problem in SA despite historical challenges – made it possible due to leadership roles in managing public health programmes and many aspects of acute / chronic care within health facilities Venturing into non-profession specific areas almost always nurse-led e.g. infection control HIV epidemic required mass scale response – nursing became obvious choice of profession to spearhead the fight Impact on society and the profession itself

Conclusion conclusion NURSES LEADING THE WAY TO 90 90 90 SUSTAINABLE DEVELOPMENT GOALS Access Equity Rights NURSES LEADING THE WAY TO 90 90 90 UNIVERSAL HEALTH COVERAGE

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