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

Article 2, paragraphs 1 and 3, of the Convention. National policy concerning nursing services and nursing personnel. The Committee notes that the National Health Policy was adopted in 2000. In particular, it notes that the National Health Policy provides for strategies for priority-based human resource development, and recommends, among others: (i) the maximization of the knowledge and skills of health personnel; (ii) the restructuring and strengthening of the Bangladesh Nursing Council (BNC); and (iii) the provision of more need-based medical education and continuous training for nursing professionals. In addition, it notes that, in the process of the formulation of the National Health Policy, a subcommittee for Designing Strategies to Develop, Manage and Implement Human Resource Development Plans was created in order to prepare specific recommendations concerning, among others, necessary steps for human resource development and appropriate staffing in the health sector. This subcommittee consisted of representatives from governmental bodies, NGOs and an international organization. In this connection, the Committee notes that a draft update of the National Health Policy was completed in August 2008. The Committee would appreciate if the Government would provide additional information on the implementation of the National Health Policy and the results obtained. It would also be grateful if the Government would specify whether and how the employers’ and workers’ organizations concerned were associated with the formulation of this policy and its update.

Article 3, paragraph 1. Nursing education and training. The Committee notes the Government’s indication that the regulations provided for under section 19 of the Bangladesh Nursing Council Ordinance, 1983, concerning the basic requirements for nursing education and training have not yet been adopted. The Committee also notes the information provided by the Government that the new structure of nursing education came into force in January 2008, which consists of a four-year bachelor programme in nursing and midwifery science, a two-year post-bachelor programme in nursing and public health and a master degree programme in nursing and relevant fields. It requests the Government to keep the Office informed of any progress made in the revision process of the Bangladesh Nursing Council Ordinance, and to transmit a copy of the amended Ordinance and its regulations once they have been issued.

In addition, according to the report of the Bangladesh Health Watch entitled “The State of Health in Bangladesh 2007”, to which the draft updated National Health Policy refers, the Committee notes that while the aim of these educational reforms is to address the domestic shortage of nursing personnel, the same report estimates that many of the graduates will find employment overseas. It understands that numerous nurses migrated to foreign countries, particularly in the Middle East, even though numbers appear to be declining in recent years. According to a study published in June 2007, during the period 1991–2004, a total of 20,825 female workers migrated from Bangladesh through formal channels. Approximately 6 per cent of the emigrant female workers were nurses, of which 87 per cent went to Middle Eastern countries (mainly Saudi Arabia) and the rest to the Far East (mostly Malaysia). The Committee requests the Government to provide information on any measures taken or envisaged in order to maintain a sustainable domestic nursing workforce. In this respect, the Committee wishes to refer to the draft WHO Code of Practice on the International Recruitment of Health Personnel, currently under preparation, which urges member States to enter into bilateral and multilateral arrangements to promote cooperation and coordination on migrant health personnel recruitment processes in order to maximize the benefits and mitigate the potential negative impact of international recruitment of health personnel, and also calls for measures in order to retain and sustain a skilled domestic health workforce by improving their social and economic status, their living and working conditions, their opportunities for employment and their career prospects.

Article 6. Working conditions of nursing personnel. Further to its previous comments on this point, the Committee notes the Government’s renewed reference to the proposal sent to the Ministry of Health and Family Welfare regarding the improvement of the present status and pay scale of nursing officers and the creation of new posts. In the absence of any new information, the Committee requests the Government to provide information on the contents of the proposal made and to keep the Office informed of any progress made in this regard.

Article 7. Occupational safety and health of nursing personnel. The Committee notes the Government’s indication that efforts are currently made in order to adapt existing laws and regulations on occupational health and safety to the special nature of nursing work, as provided for in this Article of the Convention. The Government also refers to awareness-raising campaigns on prevention and protection from various infectious diseases. Moreover, the Government refers to the Hospital Improvement Initiative (HII) which aims at creating a safe working environment for hospital team including nurses. In this connection, the Committee draws the Government’s attention to the Joint ILO/WHO guidelines on health services and HIV/AIDS, published in 2005, with a view to assisting health services in building their capacities to provide their workers with a safe, healthy and decent working environment as the most effective way to both reduce transmission of HIV and to improve the delivery of care to patients. The Committee also wishes to refer to the International Labour Conference discussion held in June 2009 on “HIV/AIDS and the world of work” with a view to adopting an international labour Recommendation, and in particular to paragraph 37 of the proposed conclusions (see ILC, 98th Session, 2009, Report IV(2), page 310) which provides that public health systems should be strengthened, where appropriate, in order to ensure greater access to prevention, treatment, care and support, and to reduce the additional strain on public services, particularly on health workers, caused by HIV/AIDS. The Committee requests the Government to keep the Office informed of any measures that might be taken or envisaged with a view to improving the protection of nursing personnel from infectious diseases, including HIV/AIDS.

Part V of the report form. Application in practice. The Committee notes that, according to the statistical information provided by the Government, there are currently 22,000 registered nurses, of whom approximately 15,000 work in hospitals or health-care institutions in the public sector. It also notes that the doctor–nurse ratio is 2:1, while the nurse–population ratio is 1:8,000. It would be grateful if the Government would continue supplying up to date information concerning the application of the Convention in practice, including, for instance, the number of students attending and graduating from nursing schools every year, the number of registered practising nurses, specific activities undertaken and results obtained through various programmes, such as the HII and the Divisional Nursing Education and Practice Network Programme, copies of official reports or studies addressing nursing-related issues, such as various studies undertaken by the Human Resources Development Unit of the Ministry of Health and Family Welfare, etc.